Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[tacoma94]

Hi,

I am a new user, this is my first day as a registered user, although I have read many of the posts on this forum. I am a male who will be 26-27 year old when I perform this surgery, which will be 1.5 years time. I am planning to use Precice Stryde, and thinking of Dr Donghoon, if Stryde is available with him. I am asking for an opinion from more experienced members, especially those who have gone through the procedure, as to an upper and lower bound on recovery time.

My stats:
168cm
(Roughly, with a measuring tape) 48cm long femur
Planned length: 5cm MAX, and going on doctor's recommendation, willing to lower this, but preferably not below 4cm.
Method: Internal femurs, Precice Stryde (or any other better method that will come out in the future)
I am fit, never had a bone injury, and healthy.

I want to know roughly how long I can take to recover. By recovery, I refer to walking at a slow to moderate pace (not quick), without aid, for a sustained period for 30 mins straight before needing some light rest.

As I understand, for 7 days after surgery, no lengthening, then you start to lengthen 1mm a day. For me, that is a minimum of 57 days of lengthening. After that, with the Precice Stryde/new nails (heard of a precice 3.0), how long before I can move as described above? I am thinking, safely, I would need 3 weeks post lengthening. My point of reference is the below diary:

- superusercj1, who did 65mm of internal femur with Paley with Stryde in 2018, said:
"Today, about 2 weeks after lengthening, I can now go up and down stairs without holding the rails. I can walk 95% normal with a cane’s help and 80% without.  The reason for this is because I’m still tight in my hamstrings and also my gluteals are super sore after walking and forcing my stride to be more narrow."
The available stats on him are: 5'3, looking to get to 5'6.  150lbs. No information is provided about his age (But I assume he is not older than me, for I consider myself relatively young for this procedure).

Relevant Info:
- 5cm is regarded as "safe" length, and ~10% of my femur length, and I am taller than the average patient for this procedure, hence I think I am in the "safe zone"
- I am young, and apparently this means my bones heal faster? (Compared to many diaries from 30+ year olds)
- I am extremely disciplined and am willing to spend 2 hrs a day 5 days a week for 6 months pre surgery to strengthen my legs and improve flexibility. I am willing to do 8 hours a physical therapy a day throughout the lengthening process.
- The technology, Precice Stryde, allows full weight bearing which allows both better therapy + shorter time to standing/walking
- Benchmarked against superusercj1 (which I know is only 1 data point), I have all the above reasons to recover as well.

Could I expect to be walking slow to moderately, with passable gait, within 90 (57 + 33) days post surgery? Thats ~ 3 months.

[dreamingtall]

I think that the bottom line is that you will be able to walk with assistance very shortly post op (2-3 weeks), which can gradually turn into less assistance. The miracle about stryde is the benefits of weight bearing. I'm 23 and will probably not have this surgery until I'm your age as well. I think that walking with assistance for you will likely be about 2.5 months (maybe less) and then you'll be able to walk without. I wouldn't worry about things like your gait now... I think those things come together for everyone but if I had to say I think maybe 4-5 months post op your gait should be back to normal ... the way I see it as long as you are able to walk you will be able to correct the gait in time

[Ghostfish]

Hi tacoma

If you are really going to stick to your goal, 5cm, I can say "yes".  You will be able to walk fairly normal for 20-30 min after 3 months post operation.  It will be possible only with Stryde.  Precice Stryde is not a right name.  It should be Stryde. Precice 3 is not a Strdye and that is the current Precice. 
But it is all possible, if you don't have any complication, accidents, or any other unwanted situation during lengthening or recovery.  Most of people do not really have much complications up to 5 cm. 

The reason I said "yes" is that 5 cm is a sort of the point where most of patients start feeling very tight and losing lots of muscles in thigh and butt.  So obviously it will take much more time to recover after 5 cm.  It is not like a linear correlationship between the lengthening amount and the recovery time.   So you will recover very fast if you do only 5 cm in femurs.  Of course it doesn't mean other people who do more than 5-6 cm can't recover.  Normally, those who did +7 cm need 5-6 months (more likely 6 months) to get back to sort of a normal life, meaning walking relatively normal, start working if the work doesn't need too much physical demand, having some fun or ordinary activities such as shopping, movies, bars, etc, but not any sort of intense sports or activities.

However, it is also hard to resist to get to over 7 cm, since we are going through a tough journey, so most of people want a max gain.  I have also seen many patients who changed their original plan (~5cm) to more gain (over 7 cm).  5 cm is also a good amount of gain too. 

Hope it helps!

[tacoma94]

Hey Ghostfish,

Thank you so much for the response! And thank you for the clarification as to PRECICE and STRYDE.

I am definitely very conservative (as much as a person considering LL can be), with a personal hard limit of 5cm and a strict policy to stop lengthening, even at 1cm, if there is any significant risk of moderate to severe damage.

However, a bit more of reading has led to some concerns about internal femurs. I have read about fat embolism and DVT, and seen at least one case where they happened to a healthy, 5'7 asian male (article on Jezebel). This was under Guichet, which to my knowledge is not a bad doctor. It was also a costly surgery, if price is any indicator of quality. I am thus extremely concerned about such a complication. As I understand, the femur is a large bone, and internal methods are invasive, leading to higher likelihood of fat embolism. In a 2018 Youtube video with Dr Paley, he mentioned 4 in 100 had fat embolism of mild to moderate severity that was rectified, with no major issues. There has been a recent reddit post by Big D on this as well. Dr Paley is already the safest in the world, signifying a very real risk with internal femur methods.

I have also heard external femur methods are extremely uncomfortable and time consuming. I am considering internal/external tibia methods. Do you have any knowledge on what reaming can do to the tibia long term, and the recovery time with say, Stryde Tibia? Is the risk of fat embolism far lower?

[Ghostfish]

Hey Ghostfish,

Thank you so much for the response! And thank you for the clarification as to PRECICE and STRYDE.

I am definitely very conservative (as much as a person considering LL can be), with a personal hard limit of 5cm and a strict policy to stop lengthening, even at 1cm, if there is any significant risk of moderate to severe damage.

However, a bit more of reading has led to some concerns about internal femurs. I have read about fat embolism and DVT, and seen at least one case where they happened to a healthy, 5'7 asian male (article on Jezebel). This was under Guichet, which to my knowledge is not a bad doctor. It was also a costly surgery, if price is any indicator of quality. I am thus extremely concerned about such a complication. As I understand, the femur is a large bone, and internal methods are invasive, leading to higher likelihood of fat embolism. In a 2018 Youtube video with Dr Paley, he mentioned 4 in 100 had fat embolism of mild to moderate severity that was rectified, with no major issues. There has been a recent reddit post by Big D on this as well. Dr Paley is already the safest in the world, signifying a very real risk with internal femur methods.

I have also heard external femur methods are extremely uncomfortable and time consuming. I am considering internal/external tibia methods. Do you have any knowledge on what reaming can do to the tibia long term, and the recovery time with say, Stryde Tibia? Is the risk of fat embolism far lower?

If you are planing on tibia, 5cm is not a really conservative gain.  In fact, 7cm in femur vs 5cm in tibia, I would say 5 cm in tibia could be harder.  In addition, you can't expect to get back to normal life after 3 months, if you wan to gain 5 cm in tibia.  Tibia lengthening is much slower and much harder than femur lengthening.  You need to expect at least 5 months or so for tibia 5 cm, before you get back to normal life.

Regarding reaming, I am not a doctor, so I can't tell you much about it.  However, most of tibia patients with moderate lengthening will recover fairly well.  Reaming seems to be not much problem in the end.  In fact is good for bone growth during lengthening and consolidation. 

As for the risk of fat embolism, this could be a real scary case.  However, the case of severe fat embolism seems to be very low or even extremely rare for respectful doctors such as Dr. Paley, Dr. Lee, perhaps many more.  I can't remember the name of tech those doctors use to reduce the risk of fat embolism.  Those doctors do try some ways to reduce the risk of fat embolism during the surgery.  Of course, if you have some serious health issues in cardiovascular system, you need to be very careful about CLL or be better to forget about it.