LL with Dr. Becker (successor of Betz) - Instagram Documentary

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Quote from: maxheight35 on November 15, 2022, 03:19:04 AMHey man, yeah I’m doing standing stretches / toe touches many times per day. Fully walking with no crutches now… it’s awesome. Slight limp but it’s getting better day by day.

That's awesome you can do all that!

The precise tibia patient in athens (the one not doing quadrilateral) came in with very flexible calves, is close to 5cm now, but it seems despite all his hard work he has some ballerina foot to deal with. (ex: on treadmill he has to walk on toes/balls of feet). He mostly stayed on his wheelchair + only occasionally used the walker and because of the non-weight bearing/fear of breaking the nail and he just can't do these standing stretches and has to wear the uncomfortable braces for alot of his stretching

I feel like this is a big argument in favor of doing tibias in Germany or France, it being easier to stretch + much less disruptive to your life. Like I have to think that standing stretches are more effective and more comfortable than braces?

I wonder why Dimitrios Giotikas in Athens doesn't have any weight bearing full internal tibia nails. I'm not sure how regulation of devices works in Athens or if there are any opinions of his affecting this. It confuses me because I think Guichet in France does use some version of the g-nail for tibias but Dimitrios Giotikas in Athens only uses g-nail for femurs. I heard that the stryde had alot of issues for tibias and maybe (?) osteolysis but I'm assuming that this doesn't happen with betzbone/guichet nail for tibias I think?

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Oh yeah I didn’t think about the regulation of certain devices and the specific countries.

Germany seems cool in most areas, but with Covid - they are still very strict and wearing masks in hospitals and the therapy clinic… and even if you fly in / out Germany they have strict mask rules on the planes. (this is why I flew into Zürich)

5cm so far on tibia is great, do you know far he’s aiming for?


Quote from: SpeedDialer on November 15, 2022, 02:20:31 PMThat's awesome you can do all that!

The precise tibia patient in athens (the one not doing quadrilateral) came in with very flexible calves, is close to 5cm now, but it seems despite all his hard work he has some ballerina foot to deal with. (ex: on treadmill he has to walk on toes/balls of feet). He mostly stayed on his wheelchair + only occasionally used the walker and because of the non-weight bearing/fear of breaking the nail and he just can't do these standing stretches and has to wear the uncomfortable braces for alot of his stretching

I feel like this is a big argument in favor of doing tibias in Germany or France, it being easier to stretch + much less disruptive to your life. Like I have to think that standing stretches are more effective and more comfortable than braces?

I wonder why Dimitrios Giotikas in Athens doesn't have any weight bearing full internal tibia nails. I'm not sure how regulation of devices works in Athens or if there are any opinions of his affecting this. It confuses me because I think Guichet in France does use some version of the g-nail for tibias but Dimitrios Giotikas in Athens only uses g-nail for femurs. I heard that the stryde had alot of issues for tibias and maybe (?) osteolysis but I'm assuming that this doesn't happen with betzbone/guichet nail for tibias I think?

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Quote from: maxheight35 on November 15, 2022, 04:29:04 PM
5cm so far on tibia is great, do you know far he’s aiming for?

5cm, so he's at his goal pmuch

It is also my goal for tibias to do next year

When I watch his (the tibia precise Athens patient) physical therapy for tibias, I sort of see some small toe and foot movements and small some knee movements but it seems like they really cannot apply that much force to stretch the tibias with their arms. Like their arms cannot apply that much force to stretch tibias compared to like... any standing stretch or even braces/night splint. Maybe when they lean in they can apply some force but I don't believe it is that much compared to standing. Then again, when he does try to stand on the treadmill, he has to be on his toes/balls of feet so I don't think the treadmill is stretching his calves that much either even though he is "standing".

---Which is making me start to believe that non-weight bearing tibias might be a big handicap, not sure, like I wonder if he could stand if he would have been constantly counteracting the ballerina foot harder (?not sure).

When I watch the physio done on him, I'm not really sure what its accomplishing because the movements are so small/not that much force but I assume they must be doing something

I wonder how tibia physical therapy (with the physical therapist, not alone) has felt for you?

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Ok yeah good idea. I’ll make some tibia stretching videos when I fly back west. I leave in a few days so will let you know.

You should consider Becker / Betz nail for your tibias. Full weight bearing is a huge advantage!


Quote from: SpeedDialer on November 15, 2022, 08:29:16 PM5cm, so he's at his goal pmuch

It is also my goal for tibias to do next year

When I watch his (the tibia precise Athens patient) physical therapy for tibias, I sort of see some small toe and foot movements and small some knee movements but it seems like they really cannot apply that much force to stretch the tibias with their arms. Like their arms cannot apply that much force to stretch tibias compared to like... any standing stretch or even braces/night splint. Maybe when they lean in they can apply some force but I don't believe it is that much compared to standing. Then again, when he does try to stand on the treadmill, he has to be on his toes/balls of feet so I don't think the treadmill is stretching his calves that much either even though he is "standing".

---Which is making me start to believe that non-weight bearing tibias might be a big handicap, not sure, like I wonder if he could stand if he would have been constantly counteracting the ballerina foot harder (?not sure).

When I watch the physio done on him, I'm not really sure what its accomplishing because the movements are so small/not that much force but I assume they must be doing something

I wonder how tibia physical therapy (with the physical therapist, not alone) has felt for you?

Edit Post

Quote from: SpeedDialer on November 15, 2022, 02:20:31 PMThat's awesome you can do all that!

The precise tibia patient in athens (the one not doing quadrilateral) came in with very flexible calves, is close to 5cm now, but it seems despite all his hard work he has some ballerina foot to deal with. (ex: on treadmill he has to walk on toes/balls of feet). He mostly stayed on his wheelchair + only occasionally used the walker and because of the non-weight bearing/fear of breaking the nail and he just can't do these standing stretches and has to wear the uncomfortable braces for alot of his stretching

I feel like this is a big argument in favor of doing tibias in Germany or France, it being easier to stretch + much less disruptive to your life. Like I have to think that standing stretches are more effective and more comfortable than braces?

I wonder why Dimitrios Giotikas in Athens doesn't have any weight bearing full internal tibia nails. I'm not sure how regulation of devices works in Athens or if there are any opinions of his affecting this. It confuses me because I think Guichet in France does use some version of the g-nail for tibias but Dimitrios Giotikas in Athens only uses g-nail for femurs. I heard that the stryde had alot of issues for tibias and maybe (?) osteolysis but I'm assuming that this doesn't happen with betzbone/guichet nail for tibias I think?

That's because stryde used stainless steel and betzbone/g nail uses cobalt chrome but they have other issues like runaway lengthening.

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Quote from: overandover on November 16, 2022, 12:57:51 AMThat's because stryde used stainless steel and betzbone/g nail uses cobalt chrome but they have other issues like runaway lengthening.

Thanks so stryde had runaway lengthening for tibias? I thought runaway lengthening was more of a ISKD problem, not sure how stryde had runaway lengthening with the magnetic mechanism and reversibility. Thanks!!

My vague memory (unrelated to the above) was that Betz said in his interview that for magnetic nails the problem is that they have to use an iron-containing metal for the magnetic mechanism. So I wonder if that is causing stryde's creators (nuvasive) to not use cobalt chrome (or maybe I'm completely misunderstanding how these metal alloys work)

I thought that the stainless steel with stryde was just causing corrosion (from stainless steel on stainless steel contact like Paley said in his interviews)

The other thing I'm sort of wondering about is whether a patient should use some angle/elevation/slant on the antigravity treadmill machine. So far they have told us not to use that treadmill feature (it has that feature to increase the treadmill slant) in Athens but I don't know why they are against it. Higher slant will mean more stretch on tibias and slightly more for hamstrings too, no? Don't know if its dangerous for the precise tibia nail or if that is a non issue

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Quote from: SpeedDialer on November 16, 2022, 03:13:28 AMThanks so stryde had runaway lengthening for tibias? I thought runaway lengthening was more of a ISKD problem, not sure how stryde had runaway lengthening with the magnetic mechanism and reversibility. Thanks!!

My vague memory (unrelated to the above) was that Betz said in his interview that for magnetic nails the problem is that they have to use an iron-containing metal for the magnetic mechanism. So I wonder if that is causing stryde's creators (nuvasive) to not use cobalt chrome (or maybe I'm completely misunderstanding how these metal alloys work)

I thought that the stainless steel with stryde was just causing corrosion (from stainless steel on stainless steel contact like Paley said in his interviews)

The other thing I'm sort of wondering about is whether a patient should use some angle/elevation/slant on the antigravity treadmill machine. So far they have told us not to use that treadmill feature (it has that feature to increase the treadmill slant) in Athens but I don't know why they are against it. Higher slant will mean more stretch on tibias and slightly more for hamstrings too, no? Don't know if its dangerous for the precise tibia nail or if that is a non issue

I mean betzbone/gnail has runaway lengthening issue. Some user recently posted that they still hear clicking sounds even after consolidation and that's causing them pain.

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Quote from: overandover on November 16, 2022, 05:57:39 AMI mean betzbone/gnail has runaway lengthening issue. Some user recently posted that they still hear clicking sounds even after consolidation and that's causing them pain.

Yeah I'm still deciding between 1 vs 1.5 vs 2 years for when to remove gnail from my femurs, I'm curious about this too. It sounds like its good remove clicking nails in case they click again later

Gonna do precise tibias in Athens about 1 year after my femur surgery

a. I could remove the nail for femurs right before I do tibias after 1 year (and recover from femur nail removal first before doing tibias).

b. I could remove the femur nail during the same day as the tibia surgery, evidently that is a thing

c. I could do the femur nail removal during the middle of a tibia precise journey

d. Or I could do the femur nail removal after the tibia precise journey.

e. Or I could do the femur nail removal way after the tibia precise journey like 2 years total after the original femur surgery = 1 year after the tibia surgery

I'm not really sure what's the best option. Dunno, what does Betz/Becker recommend for timing the first nail removal if you're planning on doing a second lengthening?

I'm willing to do a more expensive option if it significantly improve the comfort and safety ( I assume that would be a or d or e) but am not sure how much it actually matters

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You should do a consult with Becker.

You can email his assistant, Nora, directly at [email protected]



Quote from: SpeedDialer on November 16, 2022, 08:32:12 PMYeah I'm still deciding between 1 vs 1.5 vs 2 years for when to remove gnail from my femurs, I'm curious about this too. It sounds like its good remove clicking nails in case they click again later

Gonna do precise tibias in Athens about 1 year after my femur surgery

a. I could remove the nail for femurs right before I do tibias after 1 year (and recover from femur nail removal first before doing tibias).

b. I could remove the femur nail during the same day as the tibia surgery, evidently that is a thing

c. I could do the femur nail removal during the middle of a tibia precise journey

d. Or I could do the femur nail removal after the tibia precise journey.

e. Or I could do the femur nail removal way after the tibia precise journey like 2 years total after the original femur surgery = 1 year after the tibia surgery

I'm not really sure what's the best option. Dunno, what does Betz/Becker recommend for timing the first nail removal if you're planning on doing a second lengthening?

I'm willing to do a more expensive option if it significantly improve the comfort and safety ( I assume that would be a or d or e) but am not sure how much it actually matters

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Officially leaving Germany and headed to NYC.

Videos posted of me walking without crutches.

Journey continues. Thanks for the support on here.

287 followers on IG since the original post!

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