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Author Topic: Risks/Complications Of LL  (Read 61756 times)

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Alu

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Re: Risks/Complications Of LL
« Reply #62 on: December 18, 2015, 02:33:53 AM »

Do you have any idea what might be the red line here? Speaking about the insertion of the nail. Do you know if Dr Guichet uses the same technique?

I am asking myself these questions because tibia lenghtening seems to have a lot of correlation when it comes to knee problems. I was wondering if the same applies to femur lenghtening.

Typically saying 5 CM on either Tibia or Femurs always seems to be a great limit. It give you 2 inches, and if we are just talking about femurs here, 5 cm isn't that much in femurs. In fact, with femurs one might even be able to go as far as 8 cm (5 CM+ on tibia isn't a good idea for max recovery); although after that I wouldn't recommend going for tibia increase since your proportions would look weird.

So honestly If you want max gain of 8-10 and keep good recovery (we have no idea if we can get back to 100%; 90% seems close so far but who knows) then splitting the surgeries would be the most advantageous.

Also this is 4 years outdated but I'm sure it's still the same:
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LLuser1

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Re: Risks/Complications Of LL
« Reply #63 on: January 08, 2016, 11:04:31 PM »

Very good comment. There's a clear bias in the forums not to show the complications. I have been attacked several times for writing about what i have seen at a very popular doctor. Nobody gets attacked for writing nice things. Even patients with diaries try to hide negative things (they are still under treatment , how could they dare openly criticise their doctors? ) . They rather stop writing or simply don't tell the truth.
I personally believe if i went to India my experience wouldn't have been worse than what has happened to me in Germany.

Very good comment Metanoia. Popular doctors and their popular patients... don't tell the truth.
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Banned for wrongly implying a patient death/posting incomplete information and repeated spamming/bumping irrelevant threads to post about Dr Monegal/MMaker despite warning.

Madmax_01

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Re: Risks/Complications Of LL
« Reply #64 on: January 17, 2016, 05:25:50 PM »

Is it true, that you are not allowed to fly on a plane? I have read it on anold forum, that it causes tremendous pain, and it is almost unbearable to fly when you have internal rods. Of course, I mean after the lenghtening phase but before the removal procedure.
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DoingItForMe

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Re: Risks/Complications Of LL
« Reply #65 on: January 18, 2016, 07:04:35 PM »

Is it true, that you are not allowed to fly on a plane? I have read it on anold forum, that it causes tremendous pain, and it is almost unbearable to fly when you have internal rods. Of course, I mean after the lenghtening phase but before the removal procedure.
I have internal femur rods and I fly just fine with no pain. Most of the pain might be from sitting for too long while putting pressure on your rods due to the now shorter seats compared to when your femurs were shorter. This can be fixed by putting something under your feet to take the pressure off your rods and onto your feet instead. This only affects people with short tibias like me who can't reach the floor while sitting.
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8 cm gained with Dr. Paley using Precice 2.1 internal femurs in Summer 2015.
Starting height: 167 cm (5'6") Currently at: 175 cm (5'9")
Link to my experience

kieran19801980

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Re: Risks/Complications Of LL
« Reply #66 on: February 16, 2016, 05:43:13 PM »

That's an interesting post. It would be great to hear from people who had internal femurs done and if they have any complications say from two years onwards. The operation is costly both financially and in time. Considering the "cheapest" for internals in Europe is 48,000 euros not including accommodation/physio/food which is possibly another 8000 euros if one decides to stay for the entire lengthening period. ( say three months for 7.5cm) As well the person is out of work which I'm guessing for five months before walking "normally", that is nearly three months for lengthening and two months for consolidation (on crutches). That's five months out of your life and work ( if your job entails walking a lot or doing community work). It's a big sacrifice.
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Antonio

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Re: Risks/Complications Of LL
« Reply #67 on: February 15, 2017, 02:42:39 PM »

New study shows that increasing Tibia/Femur ratio beyond 0.8 is correlated with long-term arthritis.

Copy paste from link https://www.ncbi.nlm.nih.gov/pubmed/26398436:

The Association of Tibia Femur Ratio and Degenerative Disease of the Spine, Hips, and Knees.
Weinberg DS1, Liu RW.
Author information
Abstract
BACKGROUND:

When individuals with asymmetric lower extremities present for evaluation of limb-length inequality, correction can occur at the tibia, femur, or in both bones; however, there are limited data available to justify either technique. The aim of this study is to examine the normal ratio of tibia length/femur length (T/F), and to explore the relationship between T/F ratio and osteoarthritis of the spine, hips, and knees.
METHODS:

Bone lengths of 1152 cadaveric femora and tibiae from the Hamann-Todd osteological collection were measured. Degenerative joint disease was graded in the hip, knee, and spine. Correlations between the ratio of T/F and osteoarthritis were evaluated with multiple regression analysis.
RESULTS:

The average ratio of T/F was 0.80±0.03. There was a strong correlation between age and arthritis at all sites, with standardized β ranging from 0.44 to 0.57 (P<0.0005 for all). There was a significant correlation between increasing T/F and hip arthritis (standardized β=0.08, P=0.006), and knee arthritis (standardized β=0.08, P=0.008).
DISCUSSION:

Increasing tibia length relative to femur length was found to be a significant predictor of ipsilateral hip and knee arthritis. Therefore, we recommend that when performing limb lengthening, surgical planning should lean toward recreating the normal ratio of 0.80. In circumstances where one bone is to be overlengthened relative to the other, bias should be toward overlengthening the femur. This same principle can be applied to limb-reduction surgery, where in certain circumstances, one may choose to preferentially shorten the tibia.
CLINICAL RELEVANCE:

This is the first study to report long-term consequences of lower extremity segment disproportion.
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OverrideYourGenetics

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A balanced view of the risks/complications of LL
« Reply #68 on: February 10, 2018, 12:25:44 AM »

I have:

-Altered sensation in my knees when kneeling or touching them, around the IM nail insertion sites and around the osteotomy sites
-Stiffness in my knees unless I exercise regularly
-Hypersensitivity in my knees when kneeling on a hard surface
-Worse balance than before
-A left ostoetomy scar that's thin and weak, that I have to protect from getting bumped or it'll break and bleed
-Altered mechanics in my legs which led to exertional compartment syndrome when walking, requiring fasciotomy

I hope my posts and diary here don't whitewash the issues I've dealt with and continue to deal with as an LLer.  I did it and got my 3 inches without getting crippled.  Those 3 inches changed my life, but sacrifices were made.  LL is a tradeoff and there are consequences I'll have to live with from now on.

3 inches in the tibias is a lot, and more than what most doctors would recommend. I know LL is costly, but if you're concerned about complications, split the increase in height across the tibias and femurs. That way you can get 2 + 2 inches with far less risk.

how do you suggest we end our own lives?

You can go all high-tech about it :)

No, seriously, get the money for a top doctor and you'll be fine.

Fat embolism, for example, isn’t a theoretical complication, but a very real risk which is usually silenced in the forum and however happens. And there are patients from the best surgeons in the world who die from it. I’ve been told this by a very reliable source from a medical point of view.

Where did that happen and why wasn't the surgeon sued for malpractice?

Can we do anything to avoid these risks? [...] It’s better not doing more than one segment at once and even avoiding CLL if possible.

Exactly. Paley advises against doing both segments at once. I'll be doing them three weeks apart.

tibia lenghtening seems to have a lot of correlation when it comes to knee problems. I was wondering if the same applies to femur lenghtening.

I've asked Dr. Paley about knee pain following insertion of nail in the tibias. His reply:

Quote
Very little if any knee pin in our patients with CLL after tibial lengthening. I think it has to do with the minimally invasive we we insert the rod and avoid damage or irritation to the patellar tendon.

So honestly If you want max gain of 8-10 and keep good recovery (we have no idea if we can get back to 100%; 90% seems close so far but who knows) then splitting the surgeries would be the most advantageous.

Exactly. That's my research too so far after spending weeks reading a ton of patient diaries. Keep your lengthening to 5-6 cm in the femur and 5 in the tibias, and pay attention to when physical therapy during the lengthening phase become suddenly more difficult - and stop there. The extra 1 or 2cm is NOT worth the pain and complications. Think 2 years to return to normal function instead of 6 months. Do you want that? In that year and a half you might as well earn the money to pay the difference between just femurs and femurs+tibias. This is the route I'm taking.
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My diary. Tibias+femurs 3.75+3.75cm at the Paley Institute (5'5" -> 5'8") in my late 30s.
One of the last patients to use the PRECICE 2.2 nail. I met the first STRYDE patient and I strongly recommend the new STRYDE nail instead.

backrandom

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Re: Risks/Complications Of LL
« Reply #69 on: February 10, 2018, 08:17:29 PM »


Where did that happen and why wasn't the surgeon sued for malpractice?


I don't know what doctor MM talks about. All I can say is patients sign a medical consent form where it says that fat embolism is a possible side effect of this surgery. When you get this surgery you must assume that death is a possible, if highly unlikely, risk. Doctors can't be sued if you die from fat embolism since it's a well known, though highly unlikely, side effect of this surgery.
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Sanity

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Re: Risks/Complications Of LL
« Reply #70 on: August 19, 2018, 02:21:18 PM »

I think if u keep the lengthening in moderation everything will be fine
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Hamiltonzac

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Re: Risks/Complications Of LL
« Reply #71 on: December 09, 2018, 12:06:26 AM »

All you people think 5 cm guarantees you safety, lol. That is stupid. Take APO the god for example, lengthened 20 cm and now runs, plays sports and recovered completely to the extent that he can function like he did before. Then there are many people who did 5 cm and got fked up. Its about how dedicated you are and physical therapy along with the safe precautions. At the end of the day its also about luck. Lengthening is individual for everyone so stop posting this crap about how 5 cm is safer than 6 cm.

Taller in Kiev is another perfect example of someone who lengthened 11cm in his femur and Im sure hes doing better than most people here who haven't even underwent the surgery yet. If anyone cares to notice what Taller in Kiev and APO had in common was they were both motivated and had belief and of course didn't go to butchers. CLL is a different experience for everyone.
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Surgery due for 2019 in Russia with Dr. Solomin/Dr. Kulesh.
Morning height: 168cm Afternoon: 166cm
Goal: Femurs and Tibia, 12-15cm LON
20 year old male.

wants2growtaller

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Re: Risks/Complications Of LL
« Reply #72 on: December 09, 2018, 02:10:30 AM »

Yea and we are going to take some medical advice over some loser on here. You are not a doctor.
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Some of us may have ''grown'' in stature. But it seems the majority of us have yet to grow in humanity
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