People like to talk alot of biomechanics post LL on this and the old forum. Saying that LL on both segments changes your biomechanics considerably. I will try to convince you guys why that is simply not the case
First let's divide the joints (which are those affecting our biomechanics) related to legs' biomechanics; you have the hip joint, knee joing and ankle joint.
So how LL affects those?
Femoral LL: This LL greatly affects biomecanics because it changes the distances between the two "main" biomechanical joints (hip and knee). To make it simple; you gain 6cm. You went from 170 to 176. With femoral LL only the hip joint "went up" while the knee joint remained in the same distance from the earth... Thus, when you will lift your thigh to a 90 degrees (standing and rising one thigh) your feet will be 6cm further away from the floor than before. This greatly affects the biomechanics of walking and running because it means that in order to completely not lose balance, after femoral LL you will need to rise your thighs to a lower degree (thus making much more minimal movement with the hip join or coxo-femoral join).
Tibial LL: Unlike the previous LL in this LL doing 6cm you knee joins the hip and thus the distance between them remains the same. This means that once you will rise your thigh to 90 degrees your foot will be at the same distance from the floor as it was before LL. So from a purely biomechanical standpoint (not taking into account muscle damage caused by LL and all the other changes) tibial LL has a negligent effect on running and walking (if it has at all).
Quote from: YellowSpike on March 28, 2016, 03:31:30 PMI find this to be very true. And this is what BLOWS.
Femurs consolidate faster, and all doctors (Dr. G, Dr. R and Dr. P have all said this to me) prefer femurs for this reason. Less chance of complications and faster to recover.
But from someone who did 7cm in femurs...your walking will be UUUGGGLY for a while, even after consolidation. And you won't be sleeping while you're lengthening. Femur LL involves your hips (ouch), hip flexors, glutes, quads...it f*cks with everything.
The ONE thing I'm nervous about doing 3cm on tibias is the longer recovery time. I was told by Paley and Rozbruch I'd be able to get around on crutches a bit because I have a strong upper body...but still nervous about this. BUT...I'm also happy that it will be overall less painful, easier to sleep while lengthening, and once you finally do consolidate...your walking isn't nearly as ugly as the case of femurs.
Do external tibias man... And there is not such a big difference between 3-5cm on tibias with regards to recovery time (according to Catagni). It takes 6-12 months (total time in frames) and you are able to walk on crutches day 1 after surgery. Internal femurs dont heal faster... Atleast everyone dont consolidate after 3 months after lengthening... You think you are recovered since you dont have any visible stuff attached to your leg... But you are still with a frame on (even though the frame is inside your bone...)
The "internal femurs heals faster" is a myth.
Quote from: YellowSpike on March 28, 2016, 03:41:25 PMI would do external tibs, but I don't know if I can be in frames that long. Dr. Rozbruch and Dr. Paley have said that doing an inch on tibs would take around 3 months total via precice. I also challenged them on knee pain, and they both said "highly unlikely." And I trust Rozbruch and Paley (as I still do Dr. Guichet).
I have to do more research on external tibs. I just wish I could bang this out in 3 months flat. Then I might be able to get my last inch, and make it work with my career which has been taking off.
Why not do the double-cut technique? It will mean you could lengthen 1-1.5mm a day (since there are two osteotomies) which means you could be done with the lengthening fase in 20-30 days. Ask Catagni about it since he does it (I believe he was the one that actually introduced it... He doesnt use it alot though because he said that the lower osteotomy heals slower).
Still ask him about it.. A guy on the old forum who did a second LL with betz said that 6 years before he did double cut LL with catagni for 6.5cm and was frame free within 5.5 months
Quote from: Alittletooshort on March 28, 2016, 04:25:12 PMUntil now I only heard bad things about the double osteomy, that it doesn´t decrease the recovery time and only increases the risks for instance.
If Dr. Catagni could assure us that it really works and is safe it would easily beat any internal nail. Not only would it be cheaper, but you´d also have a faster recovery with full wheight bearing from day 1 AND you can avoid the permanent knee pain and the potential damage that is done to the patella by splitting it twice.
If you speak to him again, please ask him about this topic. The idea of legthening 4cm´s in less than 4 months sounds just too good to be true 
.
You can also send him an e-mail
Quote from: CCMidwest on March 28, 2016, 06:22:02 PMWhy the increase in ballerina risk? Because of the Faster lengthening? The rest of the risks I understand. Tbike, what does Catagni say about thos, have you asked him? (since you're the resident Catagni expert! )
He did say that he prefers to do single cut. Because he said that the consolidation in the lower cut is usually slower thus in the end the time is the same.
About highier chances of complications, he didnt say anything about it because he said to me (more of commanded me) to do a single cut
Sweden has foot equinus and Valgus knees... Of course he is going to have a wierd running... All of the guys that went to those stupid docs in india and some in russia completely destroyed they legs because (1) They went to surgeons that dont know how to use Ilizarov (The simple fact that they got valgus knees from an apparatus that is supposed to fix valgus knees shows how incapable those surgeons are) (2) they didnt solve the equinus foot.
ALL and I mean ALL ex Catagni patients I have spoken to said they returned to previous athletic abilities (with less endurance... Not wierd sensation of movement).
Stop taking into account people who went to surgeons in India
Quote from: theuprising on March 28, 2016, 08:12:23 PMTbike can you go into more depth when you say muscle damage and other changes caused by tibial lengthening. What are these other changes?
Sweden and others I can't remember off top of my head said when they are running with longer tibias that the mechanics are weird in terms of power transference and their running is worse than before. The best running I've seen was Oldiebutgoldie who actually did femur.
The damage is the same as with femoral lengthening. You strech the muscle. If you strech too much, you will lose functionality
Quote from: crimsontide on March 28, 2016, 11:04:46 PMtbike, I'm gonna call you out
You have presented zero evidence that even 1 patient has ever recovered 100% of their pre surgery athletic abilities
Hearsay is not evidence
I have yet to see 1 patient fully recover, and stop bringing up India. You're creating a red herring
I've yet to see 1 patient from ANY Dr fully recover athletic abilities.
You want to believe this, and that's okay
Argument by assertion is a logical fallacy
This surgery is serious. Show me proof anywhere that patients recover 100% of pre surgery athletic abilities
Hearsay and anecdote are not convincing
That's what Catagni ex patients told me via e-mail and on the phone. By your logic I should presume that your outcome is the common one? Call me out.. On what exactly?
Quote from: crimsontide on March 28, 2016, 11:14:22 PMYour reply only proves my point
You didn't even meet these people. You spoke to people you don't know by email and phone, and that is the proof?
Not very convincing
I need actual scientific studies done with rigorous testing of pre and post surgery athletic abilities
Where are your scientific studies about how horrible is ATL? You have said there are tons of studies that show how harmful it is, yet you never posted one. I look on the web and found two being done with people suffering from neuromuscular disease.
I can understand your grief by your awful decision of docs... Dont throw it on others thx 
Quote from: theuprising on March 28, 2016, 11:18:02 PMI also would like to see these studies, but you still didn't answer crimsons point you just changed the topic. Answer his question.
What question? My proof? Frankly I dont since I havent done any medical research by myself but read others' medical research and have spoken to top notch surgeons.
My proofs about this being somewhat safe are the same as your proof of this being an apocalyptic surgery
You must be logged in to post a reply.