Quadrilateral - Re downtime, functionality and complication - Dr Paley

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Hi all,

I'm now in the process of finalising my plan, and as part of that I'm considering whether to lengthen 10 cm or 13 cm. Particularly, I'm now considering the following options:

1) Combined tibia (5cm) and femur (5cm) 3 weeks apart
2) Femur (8cm) followed by tibia (5cm) 1 year later

Questions:
- What's your recommendation?
- Is there any patient that has performed a similar procedure (either 1 or 2) whose diary is available online? If so, would you please share the link (I've only found iamready's diary)

The following might be relevant:

The surgeon I'm now considering is Dr Paley, and my concerns revolve around (i) prolonged downtime, (ii) loss of functionality and (iii) complication risks.

Re (i) - my main concern is that I won't be able to return back to work within a reasonable timeframe. I can take 3 - 4 months off (in any given year), but anything beyond that, would be difficult as I will need to return to work and maintain cashflow.

Re (ii) and (iii) - while I understand that the more you lengthen the higher the risk is, but I wonder how much higher is the risk of complication between 10cm and 13cm? I'm a sporty and outdoorsy guy, so I'd like to have key functionalities as intact as possible.

More information about me, I'm 5'3. I've considered the height increase difference between 10cm and 13cm, and to me, there is a big difference between the two. And given my current height, only by lengthening 13cm I would be more or less average height (though obviously it'll still be on the shorter end considering where I live). I live in a western country and am looking to move to US one day (to give you a perspective of what I'm comparing with).

Also, the price difference between the two options is only $10,000. Yes the other price you have to pay is the time (as the second option will add another 3-4 months of downtime), but that's something that I currently consider as worth it for the extra 3cm (given all the considerations I've given above).

Look forward to hearing your comments and thoughts.

Cheers

 

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Thanks so much Michael, those links are very helpful!

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Quote from: MyEvolution on October 05, 2019, 03:21:32 PMDon’t do quad honestly its soooooo pointless. Ur essentially paying an extra $100k and going through for 2x the pain for ONLY extra 2cm? The hell??
If u do stryde femurs alone u can 100% hit 8cm
And if u then 1 yr later do tibs alone u can 100% hit 6cm
Use my diary, thats what i am currently doing

Thanks for pointing that out. I just realised that there is no price advantage for option 4. I had assumed that there was. I'll check this with Dr. Paley.

I actually came across your diary before, and (pleasantly) surprised when I saw your comment on my post - thanks for man. I might actually do that instead so I don't have to fork out over $200K upfront.

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Quote from: NormalPlayer on October 06, 2019, 07:16:43 AMCan I ask have you ever considered option 5? I mean, according to what the description said, it should be the most possible way to gain "maximum" extra height (16cm. Well I know it's expensive but I think you really want a lot of height so it might be an option for you) as it doesn't require you to lengthen too much at once, and so your body won't limit you to lengthen your legs. I personally have been considering this but I am quite afraid of doing internal tibia as I don't want to risk internal tibia even with Paley (unless he guarantees NOT to split the patella tendon.)

I do think that the more you lengthen, the more you'd likely to lose some functionality. 13cm is enough for me, so I rather to stop there.

Could you elaborate more about your concern re the patella tendon?

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Quote from: NormalPlayer on October 07, 2019, 05:50:07 PMAccording to those people who said they had done internal tibias, some of them said that internal tibia requires your patella tendon to be splitted and so the nail can be inserted. Although according to some medical passages, the surgeon could insert the nail from other position to prevent splitting the patella tendon, yet some people in this forum said Paley would just split the tendon like any other doctors. The splitting of tendon might lead to permanent knee pain, and that's the only reason I am still considering Paley about tibias (as he stated that he would not do external).

Thanks man, appreciate your reply. Would you mind quoting or linking us some medical articles (especially journal articles) that support the sentence in bold above? Not doubting that you're having those concerns, but it'd be great to be able to validate that.