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[Camillo]

Hello guys,

I lengthened 7.5 cm, but the doctor has told me I can not go further without doing the Achilles tendons.

You may think that 7.5 cm are a lot, but the doctor also told me to always consider 1 cm less than what I turned in the external fixator. Plus, once I will removed it, I will lose another 0.5 cm. So actually I did 6 cm real.

Now I have to choose whether to do the Achilles tendons or stop. If I do it, I can still lengthen 2-3 cm, reaching 8-9 cm real in the end. The doctor advises me to do this additional operation, since there are no long-term consequences.

What do you think?

[Camillo]

I forgot to add, final heigh 177 cm real

[onemorefoot]

I think you should just stay at 6 cm, if you want more you should consider femurs. I read other diaries with Pili_Catagni and normally the amount lengthened is .5 cm less than reallity, 1  cm is a Lot. Also what doctors say about lifts, can I continue using them?

[Camillo]

I think you should just stay at 6 cm, if you want more you should consider femurs. I read other diaries with Pili_Catagni and normally the amount lengthened is .5 cm less than reallity, 1  cm is a Lot. Also what doctors say about lifts, can I continue using them?

What you turn in the external fixator is always 10-15% more than your real lengthening. So 1 cm less is normal, plus you have to add 0.5 cm that will be lost when you remove it. So 1,5 cm I think is about the procedure not the doctor.

Yeah it is an hard decision, I booked for the ATL but I am thinking a lot about it.

[IwannaBeTaller]

Hello guys,

I lengthened 7.5 cm, but the doctor has told me I can not go further without doing the Achilles tendons.

You may think that 7.5 cm are a lot, but the doctor also told me to always consider 1 cm less than what I turned in the external fixator. Plus, once I will removed it, I will lose another 0.5 cm. So actually I did 6 cm real.

Now I have to choose whether to do the Achilles tendons or stop. If I do it, I can still lengthen 2-3 cm, reaching 8-9 cm real in the end. The doctor advises me to do this additional operation, since there are no long-term consequences.

What do you think?

Are your legs now 7 cms longer than before, or 6 cms?

[Camillo]

Are your legs now 7 cms longer than before, or 6 cms?

6 cm

[0184946]

if u want to do more then go for achille tendon it'll remove the worries of ballerina completely but its painful from what i hear. if ur ok now with how u feel at 6 cm then finish lengthening and do another seg in femurs later

[IwannaBeTaller]

6 cm

I don't understand why the legs would be 1.5 cms shorter than what you lengthened? Does the bone recompress again, and when does this happen?

Also, can you not measure your height while still in fixators?

[0184946]

Also, can you not measure your height while still in fixators?

im curious about this too, always wondered why people complain about x ray measurements and distraction rates not being accurate when they could just stand up and compare their pre LL height to current height thats if they dont have duck ass/BF though

[Camillo]

if u want to do more then go for achille tendon it'll remove the worries of ballerina completely but its painful from what i hear. if ur ok now with how u feel at 6 cm then finish lengthening and do another seg in femurs later

Hey friend, I don't think I will ever do femur. This is not a joke and after more than 3 months with EF I am tired. So I would rather prefer to do ATL now and get 2-3 cm more rather then stop and do femur later.

[Camillo]

I don't understand why the legs would be 1.5 cms shorter than what you lengthened? Does the bone recompress again, and when does this happen?

Also, can you not measure your height while still in fixators?

I don't know in specific how to answer this question, but there is a technical reason that the doctor explained to me regarding why what you turn in the EF is always 10-15% less than the real lengthening. So since I did so far 7,5 cm, it is something around 1 cm in my case.

You will lose another 0,5 cm when the EF will be removed, but here again, I do not know the reason exactly. This is just what the doctor told me.

[onemorefoot]

If you go for femurs would be internally, maybe is easier than external fixation, but if doctor gives you the green light go for the full 9cm.

[Zenithian]

hey cam,
i can see this decision is really difficult
you can ask the forum of course but you are going to get so many different answers here
i think you should ask Dr. Pili for contacts/email of people who have experience with AL
that is the only way to get a good idea for your decision
-zen

[Camillo]

hey cam,
i can see this decision is really difficult
you can ask the forum of course but you are going to get so many different answers here
i think you should ask Dr. Pili for contacts/email of people who have experience with AL
that is the only way to get a good idea for your decision
-zen

I did, I contacted 4 former patience of dr. Catagni and all of them told me that after ATL they recovered 100%.

[IwannaBeTaller]

How can you even lengthen a tendon?

[RealTrump]

I did, I contacted 4 former patience of dr. Catagni and all of them told me that after ATL they recovered 100%.

Yeah right. They probably mean they are able to walk 100%, and for them that is a full recovery.

[TIBIKE200]

Yeah right. They probably mean they are able to walk 100%, and for them that is a full recovery.

Why are you saying things you have no idea about.

 I contacted former Catagni patients who did ATL. All of them returned to playing sports as well (such as soccer and jogging).

 I get it that you got a  ty recovery LLcaptain, but don't make it seem as if your own  ty LL result is the norm... Well, it is if you go to the same  ty doc you went with

[Camillo]

I had Achille Tendon Lengthening, tomorrow will be 10 days already. I can stand and walk with no problem but I have of course some pain in the heel since I have 2 wires there. I will remove them in other 20 days. The cut is bad but I will remove the stitches in few days. So it seems everything fine, I'll keep you posted.

[682]

The debate on whether getting to 100% of pre-op levels is even possible at all is a contentious one as there isn't statistical evidence to back it up, but I believe most people believe there is a trade off of athletic ability when considering limb lengthening alone from what we have seen.

Now, 100% with ATL is almost certainly impossible, nevermind with limb lengthening on top of that which we haven't come to a conclusion on. Logically it just cannot be the same as how it was before - the tendon will never have that elastic power again once lengthened. There have been peer reviewed studies and have been linked recently in the 'Body Builder' thread (crimson tide anecdotally went through ATL and has stated his 'push off power' is much weaker), the user Body Builder is now considering tendon shortening because of the weakness. He linked a study - showing the difference in power, muscular size, dorsiflexion etc. after an AT rupture even after tendon shortening - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3460090/.

'The duplicate measurements showed a high intraobserver reliability (r = 0.90; P = 0.012). T test paired sampled statistics showed that the operated limb had a lower peak torque than the nonoperated leg (240.9 N ± 51.9 N vs. 299.0 N ± 44.2 N; P = 0.05), but the patients did not perceive this decrease in strength as interfering with their daily or leisure activities.' - So even if the person believes they are 100%, they most likely aren't - and this is without any lengthening which undoubtedly complicates things.

And after less than a minute of searching I found this - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3178860/ which discusses how to deal with AT injury and avoiding lengthening because of the issues it causes.

'- Tendon elongation correlates significantly with clinical outcome; lengthening is an important cause of morbidity and may produce permanent functional impairment.
- Furthermore, weakness in the end-range plantar flexion after AT repair recently has been attributed to an excessive tendon lengthening during muscle contraction.
- Moreover, increases in plantar flexor muscle cross sectional area, passive stiffness, and the ability to absorb passive energy also increase.
- Once tendon lengthening has become permanent, its clinical management is often difficult.'

Nevermind the likes of Paley advising patients to avoid it at all costs unless completely necessary.

I find it humorous how people can give anecdotal evidence and someone else can come along and say 'That's anecdotal evidence and is completely wrong, here is my own completely anecdotal evidence which is completely right!'. The issue on ATL isn't a personal one and putting forward the best evidence we have and discussing it civilly without resorting to insults would be better for all of us - even if the result of the surgery are less than satisfactory as we have to be honest about results.

----

Camillo - Best of luck with your recovery, please keep us updated.

[Body Builder]

Totally agree with 682.

Tendons need to have a certain length to keep the tension of the muscles on the right degree and exert the optimum power of the muscle.
By changing this length, especially by harming the tendon with cuts, there is no way to have again the same abilities.

So it is of course much better to lengthen less and have normal working legs from doing atl to gain 2 cm more and have from moderate working legs to completely crippled if there is a massive tendon overlengthening.

Atl is a very bad surgery and I can't understand how there are respectable doctors like Catagni that they keep doing it.
And also, I can't umderstand how many patients say that they are normal after atl. Me, crimsontide and Steve (if I remember the nickname right) have completely opposite experiences and that's why I'm going to have another surgery to fix (as I can which I'm optimist that it would be a lot) the problems that atl caused me which are much much more than tibia lengthening per se.

The only procedure to reduce equinus (but not as much as atl) that seems to cause minimal problems is gastrocnemius recession.
Atl must be avoided at all costs.

[Whereintheworld?]

The growing mindset here is to avoid ATL because you will never make a 'full recovery', but is walking around with an 'intact' achilles tendon, stretched 2 to 3 inches, actually any better? I doubt it.

[KiloKAHN]

If you lengthen too much you're in a bad position either way. Your can do a gastrocnemius-soleus recession as an alternative to Achille tendon lengthening, but the only study I saw on gastroc recession side effects said patients experience a permanent 20% decrease in strength, so I don't see it as much better of an alternative to ATL anyway.

[Camillo]

too late I had ATL, first few days have been bad, but after 2 weeks I am feeling very good now, I can walk better than before with no pain and the doctor said we will remove the wires from my feet in other 2 weeks.

I will let you know if I recover 100% or not, but I trust the doctor who guaranteed me that there are no long term consequences

I think, but it is just an opinion, a lot could be related to the method you use for ATL and how long you lengthen the tendon.

[682]

too late I had ATL, first few days have been bad, but after 2 weeks I am feeling very good now, I can walk better than before with no pain and the doctor said we will remove the wires from my feet in other 2 weeks.

I will let you know if I recover 100% or not, but I trust the doctor who guaranteed me that there are no long term consequences

I think, but it is just an opinion, a lot could be related to the method you use for ATL and how long you lengthen the tendon.

Even without long term consequences, you will not recover to 100%. The numerous studies on ATL, including the ones I had posted prove that it is not possible to return to 100%.

[onemorefoot]

Camilo, are you sure you are not 178 cm? 172+6

[Camillo]

Even without long term consequences, you will not recover to 100%. The numerous studies on ATL, including the ones I had posted prove that it is not possible to return to 100%.

I hope you are wrong. That study anyway refers to a specific case of Achille Tendon Rupture and excessive lengthening. Moreover, I have not seen many of them, I found instead (when I was searching before doing the ATL) a lot of studies about ATL that did not mention long term consequences. Moreover, ATL is done for a lot of problems, not only as a consequence of LL and equino feet. So I am not that worried honestly.

[Camillo]

Camilo, are you sure you are not 178 cm? 172+6

I checked my height before going to doctor last time, and it was 180 cm. Since then, I am doing one more cm on the right and 0.5 on the left leg (I had a 0.5 cm difference in the two legs before the LL). Considering you will lose 0.5 cm when you remove the EF, I should end up being around 180 cm.

[onemorefoot]

Oh, ok, you Will lengthen 9 cm and gain 7.5+172=180 cm.

[Body Builder]

I hope you are wrong. That study anyway refers to a specific case of Achille Tendon Rupture and excessive lengthening. Moreover, I have not seen many of them, I found instead (when I was searching before doing the ATL) a lot of studies about ATL that did not mention long term consequences. Moreover, ATL is done for a lot of problems, not only as a consequence of LL and equino feet. So I am not that worried honestly.

Atl is done mainly in people with diabetes who will get amputated if they don't do it.
Also in people with chronic tendonitis who suffer from pain and can't even walk properly
So atl is done only in very serious cases that patients risk for much bigger complications and is the last solution.

If a healthy people that wants to do a cosmetic surgery like LL believes that he is in the same situation like people who have diabetes and face the danger of amputation, and want to do atl to gain 1-2 cm more, then it is his choice.
But don't believe that your feet will be ever the same as before because the loss of tension and the weakening that go together with atl will completely change the feeling of your legs when you walk.

All these come from someone like me who did atl because he believed what his doctor told him and sees everyday how wrong he was to believe a doctor when all the researches show different things.
I hope that your case will be different and better than mine (although I've seen much worse atl cases than mine) but I really believe that atl doesn't worth at all just for gaining 1-2 cm more.
I wish you prove me wrong.

[crimsontide]

it's impossible to be anywhere near 100% after  ATL unless you get additional surgeries or special devices to aid in walking.

very bad decision , especially after everything that's been posted here. I've been warning  everyone for a long time  not  to do ATL

[Bander72]

And Catagni a big advocate of it said 70% of his patients that did 3-5  cm got the atl done.