I appreciate the response uprising. I'm not trying to justify my length, or as you call it "overlengthening". I'm quite comfortable with it and I hope to recover as healthily as some of the other longer length patients that I have met pre and post op. What I'm trying to get to (selfishly for my benefit - if my legs are going to genuinely fall off in 10 years it would be good to know), is "what are these risks and dangers that everyone speaks of"? Nobody actually itemises what they are with any tangible evidence. I have the opinion of prof betz and I also spoke to my uk LL surgeon about it, but this forum is international so affords (in theory) the opportunity to get a wider perspective.
Yes, the South African doctor (sorry, I forget his name - franz?) did reply to my question about this, but did you see the reply? I did not want to appear rude so I did not follow up but his answer was superficial and without any information. I guess he's busy and wanted to reply quickly, but maybe he doesn't really know the answer? Maybe to cover his own ass (insurance, liabilities) he just recommends a very short length because as long as he gets the business, as long as the patient is safe and the patient is happy, then the patients length doesn't really matter to him. I could be wrong about this, but it's a possibility. Guichet and betz on the other hand have decades of experience and know for a fact that longer lengths are quite practical (within the context of a procedure that is inherently risky irrespective of length).
There's a lot of hearsay and assumption around this topic, I'm simply very curious.
Of course you are entitled to your opinions. My primary goal is patient safety and this is why I make the statements about safe lengths. Yes it is technically possible to lengthen longer distances, but we need to be able to provide consistent and safe results, both short term and long term. If you read my thread, the risks like malalignment, contractures, instrumentation failures, delayed consolidation, arthritis are mentioned and explained. All of these risks rise almost exponentially for every cm beyond 5. I am glad you didn't have these complications, but for every patient that 'gets away' without complications at this length, there will be some with significant problems. With regards to your statement regarding medicolegal risk: I am sorry, but that does not play into my calculations. My philosophy is that sticking with sound principles and doing the best for the patient mitigates medicolegal risk. In other words, if I treat you properly and based on good principles, I can defend myself should the need arise.
I am sorry if you felt my previous response did not have substance. I felt that the question had been addressed in the thread already. I am indeed very busy, but if you feel my response is not complete enough at any point, either email or PM me, or post that in the thread and i will try to be more complete.
Lastly, please do not assume that i am offering this surgery purely for financial gain. My practice is busy enough. This is an additional service to my prospective patients. See my response re the ethics of CLL.
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Topic: Considering European operation in Autumn/Winter 2014 (Read 6013 times)