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[warrior]

Honestly I do not understand, why then do they want to do it?

[fivetenneeded2016]

ATL indeed is the hardest part of LL as my fellow patient's brother felt out of his experience under Dr catagni. But never the less, he is back to normal. He can jog/run/swim etc. The negativity is just due to bad experience under another doctor. I have not heard of a Pili/Catgni patient losing strength after ATL. Bodybuilder(No offense buddy _/\_) has asked this repeatedly on other Catagni/Pili patients' diaries but still isnt convienced even after they told him they are okay. It could again depend on how the surgery was performed. Even Parihar said he would do ATL in case of severe equinus.

[fivetenneeded2016]

Also its not mandatory. There are patients who have not had ATL too under Dr Pili. It kind of depends on how much you lengthen and your flexibility. Given a choice, if i reach my goal withbminor equinus, I would avoid it too. Why? Because of cost.

[Shadow91]

fivetenneeded2016 have you met patients of Pili that have done internal femur? If so how did it go for them?

[fivetenneeded2016]

fivetenneeded2016 have you met patients of Pili that have done internal femur? If so how did it go for them?

I have not met any femur patients, my friend. But for femur, why dont you goto Betz/Guichet? If you ignore the outliers, majority have good results, if you go by data based on diaries here.

[fivetenneeded2016]

fivetenneeded2016 have you met patients of Pili that have done internal femur? If so how did it go for them?

Besides I might not choose Dr Pili for femurs, if I plan for. I only opted them for the weight bearing tibial frames(I wanted pure external as I had a surgery on my knee earlier) and good results from the other diaries.

[Shadow91]

The thing is, Pili use Precise, which is much safer. Thats why i was thinking about him. But i am far from making a decision yet.

[fivetenneeded2016]

The thing is, Pili use Precise, which is much safer. Thats why i was thinking about him. But i am far from making a decision yet.

If you are going for precise go with Stryde. Trust me, weight bearing is the best thing if you want to get to normal living as soon as possible. First few days I walked very minimal, even then I lost my calm, it was just too frustrating. It then becomes a mental fatigue too if you are unable to do basic chores.

[myloginacc]

ATL indeed is the hardest part of LL as my fellow patient's brother felt out of his experience under Dr catagni. But never the less, he is back to normal. He can jog/run/swim etc. The negativity is just due to bad experience under another doctor. I have not heard of a Pili/Catgni patient losing strength after ATL. Bodybuilder(No offense buddy _/\_) has asked this repeatedly on other Catagni/Pili patients' diaries but still isnt convienced even after they told him they are okay. It could again depend on how the surgery was performed. Even Parihar said he would do ATL in case of severe equinus.

Be careful, FTN.

I recommend e-mailing as many CLL surgeons as you can if it ever comes the time that Pili suggests ATL. I'm telling you this because I've did the same... asking doctors about ATL. But do mention you're a current Pili/Catagni patient when you send those e-mails. Being no doctor, I can't give any other advice than that. Just never trust your own doctor blindly in the world of CLL.

[Body Builder]

ATL indeed is the hardest part of LL as my fellow patient's brother felt out of his experience under Dr catagni. But never the less, he is back to normal. He can jog/run/swim etc. The negativity is just due to bad experience under another doctor. I have not heard of a Pili/Catgni patient losing strength after ATL. Bodybuilder(No offense buddy _/\_) has asked this repeatedly on other Catagni/Pili patients' diaries but still isnt convienced even after they told him they are okay. It could again depend on how the surgery was performed. Even Parihar said he would do ATL in case of severe equinus.

I dont know even one patient who did atl and write here to have a good result after it. Who are they?
And we did it to at least 6 different doctors.
Also, Paley and every respectable doctor I know are totally against atl.

I dont know who are these patients that are completely ok after atl and why none of them writes here to tell us their experience. Of course, I could write whatever I want, but if you post a video of someone who did atl and can jump or run fast (not veey fast, just faster than jogging) then I will never write against that crapy surgery again.
But I am sure you won't find anyone. But I truly wait for a video like that with a patient who did LL to jump from the ground.

So dont write about things that you dont know my friend only to defend your doctor. No respectable doctor in the world performs atl nowadays (no, a doctor in India is nothing significant, when Paley says avoid atl I dont care what Parihar or Pili says) and also it is stupid to do atl after 5cm to almost anyone while at least 90% of patients could reach 6cm on tibias without any major equinus that cant be treated with pt.

Anyway, I really don't care what anyone does after all I've written. Afterall, after 5 terrible years I am very good right now after my at shortening surgery. I just dont want anyone to feel how miserable I, Crimsontide and many more felt with having weak and sloppy legs that couldnt do nothing more than a slow walking.
If you think that all these are not from atl but from the doctors that did it bad to us, them its your choice to do it and see it by yourself.
But I have warned you.

[fivetenneeded2016]

http://www. /index.php/topic,7920.msg107096.html#msg107096 (says he is fine)
http://www. /index.php/topic,7920.msg107126.html#msg107126 (you again curious abt ATL and were puzzled he could walk so soon)
http://www. /index.php/topic,7920.msg107208.html#msg107208 (he clarifying again that he feels much releived)
http://www. /index.php/topic,7920.msg107306.html#msg107306 (can walk much much better)
http://www. /index.php/topic,7920.msg107345.html#msg107345 (repeating it)
http://www. /index.php/topic,7920.msg107911.html#msg107911 (you still have your doubts)
http://www. /index.php/topic,7920.msg107912.html#msg107912 (he is again telling you he did ATL for the better)
http://www. /index.php/topic,7920.msg109144.html#msg109144 (OP says he can run)

CAMILLO(you dint ask him though, but in another thread he replied to your question)
http://www. /index.php/topic,8055.msg109195.html#msg109195 (says no issue post ATL)
http://www. /index.php/topic,8055.msg109221.html#msg109221 (suggests ATL too with a good doc, says it depends on your docs skills, and confidence. I totally agree on that front. It could depend on patients stats too,(flexibility/physique/strenght etc))

DAMN, I wrote a lot, with data, and had posted,,,but then I tried to modify it... but unfortunately the 'quote' thingy got it all messed up :/. I overwrote on top :/ See my following post to sum up most of it.

[fivetenneeded2016]

I dont know even one patient who did atl and write here to have a good result after it. Who are they?
And we did it to at least 6 different doctors.
Also, Paley and every respectable doctor I know are totally against atl.

I dont know who are these patients that are completely ok after atl and why none of them writes here to tell us their experience. Of course, I could write whatever I want, but if you post a video of someone who did atl and can jump or run fast (not veey fast, just faster than jogging) then I will never write against that crapy surgery again.
But I am sure you won't find anyone. But I truly wait for a video like that with a patient who did LL to jump from the ground.

So dont write about things that you dont know my friend only to defend your doctor. No respectable doctor in the world performs atl nowadays (no, a doctor in India is nothing significant, when Paley says avoid atl I dont care what Parihar or Pili says) and also it is stupid to do atl after 5cm to almost anyone while at least 90% of patients could reach 6cm on tibias without any major equinus that cant be treated with pt.

Anyway, I really don't care what anyone does after all I've written. Afterall, after 5 terrible years I am very good right now after my at shortening surgery. I just dont want anyone to feel how miserable I, Crimsontide and many more felt with having weak and sloppy legs that couldnt do nothing more than a slow walking.
If you think that all these are not from atl but from the doctors that did it bad to us, them its your choice to do it and see it by yourself.
But I have warned you.

BodyBuilder, I know your experience with ATL was bad and all you are doing is spreading the word. LL, the surgery, in itself is risky, there are bad outcomes in LL, doesnt mean all such patients dissuade to do it under any doctor. No offence to you, I really respect and look up to you. You know that too.
But I feel if a doctor is good and confident and has good outcomes with his patients after the surgery then it is fine. SO IT MAJORLY DEPENDS ON YOU, THE DOCTOR SKILLS, AND THE TECHNIQUE.

I dont trust Paley more than Catagni(Paley learnt from him and has very high regards for Catagni), not for tibias and definitely not for externals.
I by no means support any doc, but I dont like the baseless(without data) accusation on the doctors. I am speaking with data. If I were to do my femurs, since there is not much data on Catagni/Pili, I wouldnt go with them either. Also regarding "defending my doctor", I have written about my doctor being not responsive over mail after the surgery. So I do not take sides. I do see by experience and data, he can perform a good surgery though. He doesnt entertain otherwise.

Please name the "respectable" docs. I feel you would say Paley and few more against ATL. To you because, ATL was not good for you and some more patients, any doc performing it is "not respectable", instead of seeing the results and beliveing what these patients have to say. That way, any one with bad LL, would consider any doctor performing LL itself "not respectable".

Since you asked some places where people said they are doing fine, here...you have your comments in many of these conversations:
-----------------------

1. NOTTOOTALL: (you asked him, he had ATL..complete the link by filling old forum.org between "www." and "/index..."):
http://www. /index.php/topic,7920.msg107096.html#msg107096 (says he is fine)
http://www. /index.php/topic,7920.msg107126.html#msg107126 (you again curious abt ATL and were puzzled he could walk so soon)
http://www. /index.php/topic,7920.msg107208.html#msg107208 (he clarifying again that he feels much releived)
http://www. /index.php/topic,7920.msg107306.html#msg107306 (can walk much much better)
http://www. /index.php/topic,7920.msg107345.html#msg107345 (repeating it)
http://www. /index.php/topic,7920.msg107911.html#msg107911 (you still have your doubts)
http://www. /index.php/topic,7920.msg107912.html#msg107912 (he is again telling you he did ATL for the better)
http://www. /index.php/topic,7920.msg109144.html#msg109144 (OP says he can run)

2. CAMILLO (had ATL you dint ask him though, but he replied to you in a different thread..complete the link by filling old forum.org between "www." and "/index..."):
http://www. /index.php/topic,8055.msg109195.html#msg109195 (says no issue post ATL)
http://www. /index.php/topic,8055.msg109221.html#msg109221 (suggests ATL too with a good doc, says it depends on your docs skills)

3. Whereintheworld (dint get ATL):
http://www.limblengtheningforum.com/index.php?topic=3582.msg59803#msg59803

4. Lumiere (said he too avoided):
http://www.limblengtheningforum.com/index.php?topic=2161.msg37137#msg37137

5. Exagerate (NO ATL)
http://www.limblengtheningforum.com/index.php?topic=3481.msg69258#msg69258 (you were astonished with him lengthening so much without atl)
http://www.limblengtheningforum.com/index.php?topic=3481.msg69261#msg69261 (says he is not the onlu one)

6. Espresso (ATL, you asked him)
http://www.limblengtheningforum.com/index.php?topic=4611.msg72482#msg72482 (mentiones he did atl, see the entire conversation between the two of you)
http://www.limblengtheningforum.com/index.php?topic=4611.msg72487#msg72487 (same questions of yours. I know your intention is fine. But your doc was differnt. this thread is only about Pilis patients.)
http://www.limblengtheningforum.com/index.php?topic=4611.msg72488#msg72488 (says he is fine)

http://www.limblengtheningforum.com/index.php?topic=4397.msg68371#msg68371 (different thread where espresso asks about the rumors regarding ATL, you have your comments a few post above. here is camillo replying to you)

Shadow(might have had atl, dont know he dint update though).

KiloKahn mentioning parihars view regarding ATL:
http://www.limblengtheningforum.com/index.php?topic=634.msg11951#msg11951

"If equinous is severe he would do a tendon release. As far as losing push off strength, he said it only matters if you want to be Usain Bolt or something, but it should not affect your day to day activities or your ability to do recreational sports. He said they can lengthen the tendons with what they call percutaneous techniques, where they basically slide the fibers. It leads to a certain amount of weakness but he said the data available shows it's not a significant loss in strength. He also said that the problem is that in medicine not everything is documented and not everything can be documented either. The example he gave was that if he does CLL in 10 patients and they are all from different backgrounds with different physiques, then you cannot extrapolate the results because there will be individual differences, just like how a bunch of siblings raised the same and having the same genetics may have different allergies from each other. So there are things that are reasonable and logical but not always 100% true, which is why one can argue many different ways."
------------------------

Conclusion, not all patients under Pili/catagni had ATL(3/6 diaries had), and those who had, did well enough later on.

Regarding video of running/jumping, its people's choice if they need to put it. In case I require ATL to achieve my goal and I do it, I would post it post recovery. I do post my photos for 2-3 days before removing it later on. I am on no ones side again. I just go with the data.

If you or the OP or anyone has proper data to show ATL under Pili/Catagni is disaterous, please post it. They said all of their patients turned out fine. Assuming all is a large percentage, I still feel its a risk similar to LL under a good doc. The choice is one's own.

[Body Builder]

FTN, even Catagni says there is a loss of power.
Loss of power does not mean that you run 1 second slower at 100m, means that your legs feel different than before.
Every research that has been done on patients after atl report strength reduction at least 40% (the more the lengthening the more the reduction) and finally, what you cant understand is that it is not doctor's technique that make this surgery unacceptable, its the surgery per se.
Altering tendons length is not like lengthening the bone, it makes tension and power go completely off. Even 1cm atl will lead to terrible gait disturbance and loss of power, and most doctors do at least 2cm.

Anyway, you are so persistent about things that you don't have any personal experience. Its your right, and it is my duty to keep people away that crappy surgery.
I wonder why some people (2 exactly) that wrote me in pms' here if my tendon shortening surgery was successful because they are so devastated from their atl that think even about suicide why they don't write here to help other people to not do that surgery.
Maybe they dont care anymore because their lives are doomed, I dont know.
But I struggled a lot to get away with that insane surgery and now I live completely normal after my tendon shortening which, guess what, it made me have an bf of about 2cm. But I dont care at all, I prefer 1000 times to have strong legs with a minor ballerina than weak sloppy legs that have 500 degrees of dorsiflexion.

And finally, Catagni is a legend with Ilizarov. About tendons he doesn't know a   and his knowledge is what doctors knew 30 years before.
If you want to know about tendons and atl, ask dr Mafulli, he is Italian too and considered the best in the world about achilles tendon.
Ask him his opinion about atl and then come again here to tell us what he told you.

Anyway, I am out of this conversation. Anyone can believe what he wants, but noone can say when he is ruined from atl that I havent warned him. Anything else is up to you.

[warrior]

then all those who stretch 7-8 cm have a horse's foot ...
the streching does not stretch the tendon so much ... Then the LL works up to 5 cm maximum 5 1/2 .. And at this point I say it's worth ..?
I have to operate in October / November with Catagni but at this point I want to know more about the extension of the ATL ..
On the forum there is a patient LUMIERE who finished the other year, did 7.5 cm on the tibia without doing ATL says from what I read that has only a little tension in the calf .. but at this point or is very lucky or ......

[warrior]

http://drpiliortopedico.it/wp-content/uploads/2015/08/IMG_1853.jpg

[warrior]

http://drpiliortopedico.it/wp-content/uploads/2015/08/PRIMA-E-DOPO-8-cm-1-mese-post-rimozione-11-mesi-post-op.jpg

[warrior]

practically on the page says that the patient 1 month after the removal of the apparatus dances .... it has only some difficulty to run and has done ATL as seen from the previous link

[warrior]

in my opinion OH SO ARROGANT did not talk to the patients ... I realized that many people speak but do not have the courage or funds and try to discourage instead those who want to do it and have the possibility ... even though the risks of problems there are and ATL is one of these

[myloginacc]

http://drpiliortopedico.it/wp-content/uploads/2015/08/PRIMA-E-DOPO-8-cm-1-mese-post-rimozione-11-mesi-post-op.jpg

Wow, 8cm on tibias.

That's crazy and too much. How will his knees and tibias support all that upper body and femur mass over the decades? His t/f ratio is fxcked.

I wish the man in the pic the best, but I can't see him being fine in the long run. He should have split whatever his desired height was in 2 LL procedures, separated years apart. At least the looks of his tibias can be improved over time, as he recovers from LL and adds the muscle and fat back there.

I realize people don't want to go through LL more than once in their lifetime, and want the most "bang for their buck", but I am of the opinion we're all lucky height can be increased at all and that the long term matters more. Lengthen less, don't lengthen more than one segment at the same time, etc.

Of course, I'd also understand it more if the man was less than 170cm. Lengthening both segments in one's lifetime may not (and is probably not) possible for everyone, and for men under 170cm it is understandable they'll try pushing the limits.

It does worry me, though; people with shoulder/elbow arthritis have difficulty lifting really low weights. That can't translate well to your legs in old age, and too big of tibias for shorter femurs are associated with developing arthritis in the knees and hip.

[warrior]

those are procedures you do once in a lifetime ... unless you're dwarfed

[Johnson1111]

8cm on Tibias just seems like a lot. His proportions are pretty shxt but he got the height I guess. For everyone trying 8cm+ on the tibias i'm sure there are multiple problems for every outcome like this.

Again I don't try to being negative but just look at him. He did ATL too? Looks horrific.

[myloginacc]

those are procedures you do once in a lifetime ... unless you're dwarfed

In no way that means a 173cm man should go for 8cm in his tibias, only to look so disproportionate and risk so much pain later in life.

Sweden was in the exact same situation and height (173cm) and always stressed to not go over 5cm - after he did go over that number himself.

Your legs won't ever be the exact same after LL. Don't be greedy and go over the quoted safer numbers for the bones unless you have a very good reason to try (this generally involves being super short).

You can also say it's a once in a lifetime thing, and that may be true for femurs. But the more you lengthen your tibia, the worse your t/f ratio will become, and that's associated with a horde of problems.

8cm on Tibias just seems like a lot. His proportions are pretty shxt but he got the height I guess. For everyone trying 8cm+ on the tibias i'm sure there are multiple problems for every outcome like this.

Again I don't try to being negative but just look at him. He did ATL too? Looks horrific.

To be fair here, it says the picture was taken 1 month post frame removal, if I'm not mistaken. Naturally, the muscles are all atrophied. The appearance should improve over time, but the disproportional looking tibias won't.

[warrior]

http://drpiliortopedico.it/wp-content/uploads/2015/08/DSC_1856_20160706_170621-e1468154719604.jpg

[Body Builder]

http://drpiliortopedico.it/wp-content/uploads/2015/08/PRIMA-E-DOPO-8-cm-1-mese-post-rimozione-11-mesi-post-op.jpg

He looks really bad.
And a respectable doctor dont let a patient go so much out of proportions, not only for aesthetical reasons but for medical reasons too un the future.

I did 7.5cm at an 1.68 height and I look way better because my tibias were too short.
That man looks really bad. He should have lengthened femurs or not go over 5cm on tibias.
I used to suggest Pili and Catagni for external LL but with all that cases of so much out of the safe zone lengthening and the frequency they do atl they start to seem like doctors for a freak show.

[myloginacc]

He looks really bad.
And a respectable doctor dont let a patient go so much out of proportions, not only for aesthetical reasons but for medical reasons too un the future.

I did 7.5cm at an 1.68 height and I look way better because my tibias were too short.
That man looks really bad. He should have lengthened femurs or not go over 5cm on tibias.
I used to suggest Pili and Catagni for external LL but with all that cases of so much out of the safe zone lengthening and the frequency they do atl they start to seem like doctors for a freak show.

Yeah. That guy's tibias were already on the longer side. That contributed to it.

This is the first LLer I see that I clearly think "this is noticeably disproportionate". I never had that impression before with the after pics. EDIT: Even for that 170cm guy who did a 12cm a mockup of tibias + femurs.

[Johnson1111]

Pili is still taller than him. Pili is about 5'10" from my estimates.

[myloginacc]

Pili is still taller than him. Pili is about 5'10" from my estimates.

Nah, that can't be right. The LLer is now 181cm (just over 5'11). I think they look about the same height now. So it's more like Pili is 5'11.

[Johnson1111]

Nah, that can't be right. The LLer is now 181cm (just over 5'11). I think they look about the same height now. So it's more like Pili is 5'11.

I fxcking suck with the cm to height. I'm just gonna stop commenting on it.

Anyway yes keep in mind Pili has no footwear on either

[419]

Hi, Prakash - welcome back. Do you have more information on this topic?

Hei, thanks a lot. Not much, I wrote what I know. I think the best thing to do is to maybe get inputs from 5-6 good LL surgeons on the topic and make the decision. Thanks.

[Johnson1111]

That side by side surely isn't accurate? He's 5'11" towering over his 5'8" self? I don't see that being realistic.

[419]

Nah, that can't be right. The LLer is now 181cm (just over 5'11). I think they look about the same height now. So it's more like Pili is 5'11.

I hear Parihar is like 6'1-6'2, he does not need to perform LL on himself for sure