Admittedly, I've not consulted with Dr. Parihar, and I have heard a lot of positive things from this forum about him and his practice. I have consulted with Dr. Birkholtz, and he would be my choice. I asked him how many CLL cases he has done with the Precise, and his response was "about 20. We feel good about the procedure, and we know the nail."
A large majority of the folks that go through CLL, regardless of Dr., will not post a diary, or post anything at all, so it doesn't surprise me. I'm still very uncertain of whether I will post a diary of my procedure. Dr. Paley has the most experience with the Precise nail (I think his count is in the hundreds), yet there are not hundreds of Paley diaries here, only a handful. The needle between Drs. Parihar and Birkholtz swings to Dr. Birkholtz for me due to his busy non-CLL practice (which I also saw with my consultation with Dr. Paley), his frank demeanor, his reputation, and the quality of the hospital.
Dr. Birkholtz vs Dr. Parihar Precise II Femurs
Quote from: goldenegg on March 15, 2017, 09:44:16 PMPenguin is his first and only precice patient so far and I think it's still a bit too early to judge the outcome. It's a little concerning since he has not consolidated yet over 6 months post op, even though he is a pretty young guy. hopefully it's just a case of bad genetics and just really slow consolidation which could happen to anybody. I'm hoping I'm completely wrong about my concern and wishing the best for you penguin to have a great outcome at the end of your LL!
I don't know if it's bad genetics, but during lengthening I was told not to weight bear to avoid preconsolidation, the side effect of that being slow consolidation later on. Also I was lazy for a month or so after lengthening was done, partly because my left achilles area started aching and became sore as hell randomly(yes, achilles area during a femoral lengthening experience, go figure) and basically did nothing for 30+ days. My callus is steadily improving so I'm not concerned unless callus can disappear/reduce/dissolve after a certain period of time despite consistent weight bearing, which I haven't heard of. But yes, if I had to guess I will probably walk unaided around 8 months post-op. Personally it doesn't phase me and I believe anyone that does LL should be prepared for a longer time frame. Don't look at the people walking 4-5 months post op and make plans.
Dr. Parihar has a very good reputation and frank demeanor as well.
The number of Precice cases is a plus on Dr. Birkholtz though. But his first Precice patient was from this forum and he recovered fine. iirc he was walking pretty close to normal in 6 months.
Not a knock against Dr Birkholtz at all, but I would go to Dr Parihar again if I had a desire to do femurs. India has a bad rep for CLL, not without good reason, but I really believe he's cut from a different cloth than all the other Ilizarov surgeons over there. He had better bedside manner than my own doctors here in the US and he never responded to my concerns with "don't worry". He wasn't afraid to tell me either if he was disappointed that I was not sticking to my PT as well as I should.
With the Precice manufacturer sending a rep to be present during the surgery, I think the number of times Dr P has used the Precice itself is really a non-issue here. When he says inserting a nail into the femur is the same process whether it is the Precice or not, I believe him. He's inserted nails into the femur plenty of times so it's not like nail insertion in itself is new to him. Plus, he's the one who went around India teaching other doctors how to use the hexapod external fixator when it was introduced, so I don't doubt that he can use new technology. He's not an "experimental" surgeon and won't do things that have unnecessary risk, like cross-lengthening or quadrilateral lengthening, neither will he do forearm CLL, so if he were uncomfortable using an extending nail like the Precice he would surely say so. It's not like he's getting extra money if you use it with him.
Other points for him, imo:
25+ years experience
Trained by Dr Paley
Primarily a reconstructive surgeon who treats patients with injuries or birth defects (meaning he knows how to treat/prevent a ton of complications that come with lengthening)
Conservative treatment recommendations
Good bedside manner but tells it like it is
Picky about who he will accept as a CLL patient
Friendly nursing staff
If you're international he will have someone there to act as your caretaker for the first week in the hospital
Has a guy who makes custom orthotics that you can order just about anything from
PT is no extra cost if you do it in the hospital and if they travel to your hotel it's really inexpensive
Easy to get a hold of him or Dr Ahuja once you're a patient
The tea they make in the morning at his hospital is so amazingly tasty
Quote from: Penguinn on March 16, 2017, 07:14:52 AMI don't know if it's bad genetics, but during lengthening I was told not to weight bear to avoid preconsolidation, the side effect of that being slow consolidation later on. Also I was lazy for a month or so after lengthening was done, partly because my left achilles area started aching and became sore as hell randomly(yes, achilles area during a femoral lengthening experience, go figure) and basically did nothing for 30+ days. My callus is steadily improving so I'm not concerned unless callus can disappear/reduce/dissolve after a certain period of time despite consistent weight bearing, which I haven't heard of. But yes, if I had to guess I will probably walk unaided around 8 months post-op. Personally it doesn't phase me and I believe anyone that does LL should be prepared for a longer time frame. Don't look at the people walking 4-5 months post op and make plans.
During my first nights in the hospital for tibia lengthening I had a bunch of pain in my thighs, especially the right one. Funny how that works.
Thanks KiloKahn for your informative reply as well as Penguin and SAD. One question, is Birhkoltz trained by paley or has any affiliation with him? I also see he is dedicated to several cosmetic and plastic surgeries other than limb lengthening, he has it here on his site: http://ffbirkholtz.co.za/
are they the same people 
with regards to the topic, one thing tempting towards Dr. Franz is that he offers a full package of sorts and his patients have access to a residence, a PT centre, gym, concierge services, etc.
I might be wrong, but some of these things you might have to figure out yourself otherwise.
In the end, what matters most is the technical expertise and care and I think both these doctors are extremely good in both these criteria.
Kilo, do you know why Cross lengthening is risky?
Quote from: KiloKAHN on March 16, 2017, 05:43:11 PMDuring my first nights in the hospital for tibia lengthening I had a bunch of pain in my thighs, especially the right one. Funny how that works.
I think it's the short segment having a Napoleon complex tantrum.
Also, the secret to their tea... a lot of sugar. That's about it. 
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