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[TIBIKE200]

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).

[YellowSpike]

I 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.

[TIBIKE200]

I 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.

[YellowSpike]

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.

I 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.

[TIBIKE200]

I 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

[CCMidwest]

I 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.

I also would do internal tibia over external for sure, if there was relatively low risk of permanent knee pain. But from the journal's knee pain seems likely. Why does Dr. Rozbruch and Dr. Paley say otherwise you think?

[YellowSpike]

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

Wow...that's amazing. 6.5cm and frame free in 5.5 months...he must have had amazing consolidation. But I will ask Dr. Catagni about this. Thanks!

I don't mind scarring, because I have hairy legs (and you can fix scars if they get terrible). And I think for only 3cm, the scarring shouldn't be that bad.

[YellowSpike]

I also would do internal tibia over external for sure, if there was relatively low risk of permanent knee pain. But from the journal's knee pain seems likely. Why does Dr. Rozbruch and Dr. Paley say otherwise you think?

I'm guessing because they're just higher quality doctors than many of the others out there and maybe they just get less complaints about it? I don't know. I have to do more research on this too, and also really press the issue when I start to prepare for doing tibs.

If there's a way I could do external and be frame free in like 4 months at the max, I'd consider it.

[Alittletooshort]

Until 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  .

[TIBIKE200]

Until 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

[YellowSpike]

Until 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're right...it does sound way too good to be true. I really want to somehow do this within 3-4 months max, but I only want another inch, so 2.5cm. I honestly really think I will be happy at 5'9", plus I don't want my legs to end up looking too long. I look fine now, and I might even be able to get away with 5'10", but for time, proportion and safety purposes, I will be happy at 5'9" which, to me, is the lowest of the heights where you're mostly safe.

I will write Dr. Catagni and ask about this.

[CCMidwest]

You're right...it does sound way too good to be true. I really want to somehow do this within 3-4 months max, but I only want another inch, so 2.5cm. I honestly really think I will be happy at 5'9", plus I don't want my legs to end up looking too long. I look fine now, and I might even be able to get away with 5'10", but for time, proportion and safety purposes, I will be happy at 5'9" which, to me, is the lowest of the heights where you're mostly safe.

I will write Dr. Catagni and ask about this.

This is what gets me. If you are willing to do this twice (for 1"! Go 1.5" and call yourself 5'10) and top doctors like Paley and Rozbruch risk severe repercussions if they disable people...is LL really the big bad boogy man people say it is?

I realize there are bad doctors, I'm not naive, I understand that some doctors would hack people up for money with no thought of their welfare, but really?

Would someone like Paley really operate on say, iamready, back to back like that...without a reasonable expectation of recovery?

I've talked to 2 LL patients irl, both are happy...

[YellowSpike]

This is what gets me. If you are willing to do this twice (for 1"! Go 1.5" and call yourself 5'10) and top doctors like Paley and Rozbruch risk severe repercussions if they disable people...is LL really the big bad boogy man people say it is?

I realize there are bad doctors, I'm not naive, I understand that some doctors would hack people up for money with no thought of their welfare, but really?

Would someone like Paley really operate on say, iamready, back to back like that...without a reasonable expectation of recovery?

I've talked to 2 LL patients irl, both are happy...

LL is not the boogeyman...it's the bad doctors that are.

I mean...I did it with a top doctor (Dr. Guichet), and aside from the fact that I'm not quite where I'd like to be height-wise (really want to be in the 5'9/5'10 range, no lower than 5'9" at night), I am actually pretty happy with the results. My only recovery-related issue is the left screw issue I've complained of often on here (hope to get that fixed in May). But I'm now jogging up and down stairs no problem, just looks a bit funny due to weak glute medius (thanks to the left screw issue). I went out partying Saturday night and was dancing exactly as before LL (complete with hip movements, jumping up and down, squatting while grinding with girls lol etc.).

I just need a bit more height. I honestly feel so close and yet so far to being over this. 5'9" I think is the start of where your height is at least good, and I honestly can't fathom why anyone a legit 5'9" at least would want LL aside from just wanting to be tall.

[CCMidwest]

LL is not the boogeyman...it's the bad doctors that are.

I mean...I did it with a top doctor (Dr. Guichet), and aside from the fact that I'm not quite where I'd like to be height-wise (really want to be in the 5'9/5'10 range, no lower than 5'9" at night), I am actually pretty happy with the results. My only recovery-related issue is the left screw issue I've complained of often on here (hope to get that fixed in May). But I'm now jogging up and down stairs no problem, just looks a bit funny due to weak glute medius (thanks to the left screw issue). I went out partying Saturday night and was dancing exactly as before LL (complete with hip movements, jumping up and down, squatting while grinding with girls lol etc.).

I just need a bit more height. I honestly feel so close and yet so far to being over this. 5'9" I think is the start of where your height is at least good, and I honestly can't fathom why anyone a legit 5'9" at least would want LL aside from just wanting to be tall.

Thanks yellowspike.

I dance like a white boy anyway, so if my dancing was at 80%, no one would know!

I'm glad you are healthy and happy. I can also see why you want more than 5'8, I am almost 5'8 and it is a strange height.

I could be happy at this height, and have been happy 90% of the time. But that potential to be taller KILLS ME.

[KiloKAHN]

You're right...it does sound way too good to be true. I really want to somehow do this within 3-4 months max, but I only want another inch, so 2.5cm. I honestly really think I will be happy at 5'9", plus I don't want my legs to end up looking too long. I look fine now, and I might even be able to get away with 5'10", but for time, proportion and safety purposes, I will be happy at 5'9" which, to me, is the lowest of the heights where you're mostly safe.

I will write Dr. Catagni and ask about this.

To give a perspective against the double cut method, Dr Parihar told me that you're just asking for trouble by doing it for CLL. He said that double cut osteotomies are done in corrections sometimes, such as when the bone is bent like a bow, but for a cosmetic case it just exposes the patient to more problems than necessary. It's easier to get ballerina foot with the double cut method, which means if you go that route you might get ballerina even when lengthening the small amount you're looking for. And if your body has poor regenerate, it will happen in two osteotomy sites instead of just one, making your issue twice as bad as it would have been. It's almost always the case that one osteotomy site will heal before the other too, meaning you're not going to be healing faster than someone with a single osteotomy. Dr Parihar even said that there have been studies showing the double cut method doesn't result in any statistically significant speed up in recovery time compared to a single cut osteotomy. So you're just giving yourself more issues by doing it.

[CCMidwest]

Why 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! )

[TIBIKE200]

Why 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

[goldenegg]

there's youtube video that was posted somewhere before that I think demonstrated the impact of proportions pretty well.  in tibial LL if there's a change in ankle dorsiflexion that can also impact biomechanics

[Ozymandias]

Any change in your femur-tibia ratio will affect your biomechanics, period.

Which one is worse, I don't know. But one more time, not going over 5 cm will help to avoid critical changes.

[theuprising]

Tbike 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.

[crimsontide]

tibia femur proprtion  is a huge issue if you do tibiae

what is going to have  big adverse consequences is losing dorsiflexion

sweden has issues running because his dorsiflexion is very bad.. he still has a bit of ballerina...

dorsiflexion is the mot important variable when it comes to lengthening tibiae

[TIBIKE200]

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

[TIBIKE200]

Tbike 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

[Thatdude950]

That squat mechanics video is awesome, I've seen it before and it helped me much better understand the way my body fits together.

The thing about LL is that if you do femurs re: squats it hurts you in two ways. for starters longer femurs make things trickier biomechanically, but nowhere near impossible. to compensate usually long femured lifters allow their knees to travel forward quite a bit past their toes (as seen in the vid). this requires decent ankle flexibility. We all know that LL can really take a toll there. Longer femurs and significantly much less flexible ankles alone are enougth to make re-developing a decent squat pattern extremely challenging. When you add in broken bones/stretched muscles ... it's no wonder we never see any decent post LL squats.

[KiloKAHN]

Why 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! )

I don't remember his explanation for why equinus shows up faster in double cut osteotomies. I think it had to do with the muscle tolerating the lengthening worse if distraction is done from two areas on the same segment.

[crimsontide]

tbike, 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

[crimsontide]

and tibia/femur proportion is not a huge issue when doing tibiae... typo

But  ankle dorsiflexion  is

[TIBIKE200]

tbike, 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?

[crimsontide]

Your 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

[TIBIKE200]

Your 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

[theuprising]

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

I also would like to see these studies, but you still didn't answer crimsons point you just changed the topic. Answer his question.