Sounds great! What did he do, just stretching? I like my PT too, releases the tension...
And I agree people in General are not open minded but who can blame you for living your dream?! No one should...
Quote from: Aturro on July 22, 2015, 11:44:35 PMSounds great! What did he do, just stretching? I like my PT too, releases the tension...
And I agree people in General are not open minded but who can blame you for living your dream?! No one should...
Mostly stretching lower muscle and releasing tension. I have not really stretch this level before.
Overall I felt good yesterday. Doctor got me heating pad and am using every now and then. Claudio wants ice over heat pad but me personally prefer heating pad. I asked them ice here but did nit get any. I didn't bother again.
The hot shower really helps as well. When I ma stiff or discomfort I took nice long shower. Yesterday I had three. Feel great each time. One thing I am missing is bath tub. I used to stay in bath tub with hot water and Epsom salt for long time. It defiantly alleviates stiffness. I learned that from Dr. Betz patient.
Overall going well so far. I should hit 8mm end of the day.
Quote from: theuprising on July 22, 2015, 06:41:21 AMHey cooper I am curious to know what Dr Monegal thinks of your femur lengthening with Paley. There were a few topics on the forum a couple of months ago talking about how internal femur by lengthening along the anatomical axis caused malalignment. Dr Monegal then wrote that his reverse planning method avoiding this malalignment particularly when using fitbone.
I assume that the device isn't important and that the reverse planning of femurs could have been done with Precise.
I forwarded the question to dr. Monegal and he replied with below response:
Lengthening along the anatomical Axis in the femur can cause deviation in valgus due to the shape of the bone.
It has been studied and they concluded That lengthening with an internal Rod along the anatomical Axis of the femur migth cause malalignment by deplacing 1 mm/cm lengthened the MAD (mechanical Axis deviation).
However every single case has to be studied and plannified preoperatively and for a 6cm lengthening the deplacement is very nitchy (6mm).
Antegrade lengthening with internals does not allow Any correction of the mechanical Axis so My recomendation would be:
1- patients with sligth varus in the mechanical axis MAD < 6 mm can do either Antegrade or retrograde procedures
2- patients with previous valgus or with deviations in the mechanical Axis MAD > 6 mm retrograde procedure planned using the reverse planning method.
In your case your Axis post operatively looks perfect. In male patients Axis is likely to be sligth varus (so was yours) and your final result has been excellent in My opinion.
Quote from: Cooper on July 24, 2015, 10:35:59 AMI forwarded the question to dr. Monegal and he replied with below response:
Lengthening along the anatomical Axis in the femur can cause deviation in valgus due to the shape of the bone.
It has been studied and they concluded That lengthening with an internal Rod along the anatomical Axis of the femur migth cause malalignment by deplacing 1 mm/cm lengthened the MAD (mechanical Axis deviation).
However every single case has to be studied and plannified preoperatively and for a 6cm lengthening the deplacement is very nitchy (6mm).
Antegrade lengthening with internals does not allow Any correction of the mechanical Axis so My recomendation would be:
1- patients with sligth varus in the mechanical axis MAD < 6 mm can do either Antegrade or retrograde procedures
2- patients with previous valgus or with deviations in the mechanical Axis MAD > 6 mm retrograde procedure planned using the reverse planning method.
In your case your Axis post operatively looks perfect. In male patients Axis is likely to be sligth varus (so was yours) and your final result has been excellent in My opinion.
I wonder if this axis malalignment is a big deal or not as there have been many patients who did over 6cm with docs like betz, guichet and paley as I have never read any other docs other that monegal even mention the option of reverse planning. Perhaps it takes years for the result of malalignment to show itself?
Quote from: Cooper on July 21, 2015, 09:08:26 AMHe uses super patellar approach which completely avoids tendon. The insertion is done few cm top of knee. It is amazing!
From what I saw on the photo you posted of your legs and what I understand from your statement above, Dr. monegal drilled through your femur to get to your tibia.
Is this correct?
femur is a bone
your bone is not drilled or broken
Hey yellowspike, did Dr. Guichet give you a reason why he demanded you stop at 7cm?
Quote from: crimsontide on July 27, 2015, 03:35:18 PMfemur is a bone
your bone is not drilled or broken
Thanks for telling us that the femur is a bone. What a sharp and incisive observation.
Also, if you think you can get limb lengthening without breaking your bones, you might want to reboot and read this entire website again.
Back in the real world, in order to insert the Fitbone nails, the bone (tibia or femur) has to be reamed/drilled for the metal rod to fit into the medullary cavity (which contains the bone marrow).
Cooper is doing his right tibia and he has mentioned that Dr Monegal uses a different approach (suprapatellar), which avoids the patellar tendon by inserting the nail above the knee. If you look closely at the photo he posted of his leg, you'll notice the bandage covering the cut above the knee.
http://s5d2.turboimagehost.com/sp/09f7dd93a167e7a741578aae251271cf/My_nice_looking_leg_but_broken_and_bloated.jpg
But you can't insert a nail in the tibia through a cut above the knee without reaming/drilling through the lower femur. Get it?
That's why I'm asking Cooper to get some clarification from Dr Monegal, so we can all become more knowledgeable about this approach (and what it means in terms of safety and results).
DINGO,
since you're going to act like a child, I'll treat you like one
I had surgery with monegal, so no need for me to look at Copper's scar and ponder
Yes, the bone has to be reamed.. The femur ,of course, does not have to be reamed when one is doing the tibia... Suprapatellar approach simply means the patellar tendon is not cut, and insertion is through the quadriceps, not the femur. The femur should not be reamed You can actually read about it online
If you actually spent any time reading, you would know why some want to use this approach
I'll tell you why though, since clicking the search button can be very difficult
It's called anterior knee pain
@crimsontide
I'm not questioning the motives for the technique (avoiding tendon pain later) or Dr Monegal or anything like that. In fact, he's on the top of my list of prospective doctors. That's why I'm so interested in knowing more about his technique.
I'm interested in the technical aspects of his tibia insertion technique because I'm finding it hard to wrap my head around the idea that one can insert the nail above the knee whilst avoiding the lower femur, that's all.
Maybe I'm looking at the wrong bandage in Cooper's photo of his leg (the one closest to the camera in the middle of his leg just above the knee). Maybe the nail was inserted through another cut. That's what I'd like to know.
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