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Author Topic: Tibia Lengthening (Precice 2.2) with Dr Assayag  (Read 30825 times)

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Height Journey

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #124 on: November 05, 2022, 02:10:32 PM »

Day 113 – Second X-rays in Consolidation, Consolidation Itinerary, New Before and After Photos, +3.7cm (1.46 inch)

https://heightjourney.wordpress.com/2022/11/05/day-113-second-x-rays-in-consolidation-consolidation-itinerary-new-before-and-after-photos-3-7cm-1-46-inch/
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3.7cm tibias with Precice 2.2 nails in 2022
7.0cm femurs with Precice 2.2 nails in 2021

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informationispower

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #125 on: November 05, 2022, 03:21:34 PM »

The difference between post femurs and post tibs with assayag is crazy. As if he is wearing lifts in the pic post femurs (you both wear shoes in that pic as well). I am guessing he is somewhere between 5'6-5'7 range
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hippo60

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #126 on: November 05, 2022, 04:15:43 PM »

Day 113 – Second X-rays in Consolidation, Consolidation Itinerary, New Before and After Photos, +3.7cm (1.46 inch)

https://heightjourney.wordpress.com/2022/11/05/day-113-second-x-rays-in-consolidation-consolidation-itinerary-new-before-and-after-photos-3-7cm-1-46-inch/

Great update! The difference between the photos is crazy, I imagine it's also your posture / being able to stand straight better no?
Also do you mind checking out my previous message? Had a few more questions for you :)
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Height Journey

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #127 on: November 05, 2022, 04:34:21 PM »

My doctor is 5'8". In my new "after tibia" picture, I re-lengthened 2mm more and was able to stand a little more straight, especially at the knees.

@hippo60, about your previous post, I recovered most of my range of motion (ROM) by month 8 femurs. After tibia surgery, most of the tightness was in the calves, ankles, and hamstrings. I lost significant ROM in the hamstrings because it is interconnected with the calf muscles. But I am recovering my ROM back as time passes and I do more PT.

I had several months after month 8 femurs to walk around in public and enjoy my new femur height. I noticed a significant difference for the better.
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3.7cm tibias with Precice 2.2 nails in 2022
7.0cm femurs with Precice 2.2 nails in 2021

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hippo60

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #128 on: November 05, 2022, 06:15:28 PM »

Thank you, that's helpful!
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SpeedDialer

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #129 on: November 05, 2022, 09:13:30 PM »


@hippo60, about your previous post, I recovered most of my range of motion (ROM) by month 8 femurs. After tibia surgery, most of the tightness was in the calves, ankles, and hamstrings. I lost significant ROM in the hamstrings because it is interconnected with the calf muscles. But I am recovering my ROM back as time passes and I do more PT.


I thought about this a bit. I plan to do internal tibias about 1 year after internal femurs. The PT's in Athens said that for internal tibia patients, they said they don't do hamstring stretches/other stretches for the thigh for tibia patients during PT. But I wonder if I should be doing hamstring stretches on my own even during internal tibias someday based on this hamstring-calves connection.

Something that freaks me out a bit is just how close the tibia is to the skin (can feel the outline of the shin bone easily with fingers) which makes me wonder if certain stretches are not safe to do when that bone is broken
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Height Journey

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #130 on: November 06, 2022, 07:33:16 PM »

I thought about this a bit. I plan to do internal tibias about 1 year after internal femurs. The PT's in Athens said that for internal tibia patients, they said they don't do hamstring stretches/other stretches for the thigh for tibia patients during PT. But I wonder if I should be doing hamstring stretches on my own even during internal tibias someday based on this hamstring-calves connection.

Something that freaks me out a bit is just how close the tibia is to the skin (can feel the outline of the shin bone easily with fingers) which makes me wonder if certain stretches are not safe to do when that bone is broken

Yes, it's a good idea to stretch your hamstrings.
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3.7cm tibias with Precice 2.2 nails in 2022
7.0cm femurs with Precice 2.2 nails in 2021

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SpeedDialer

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #131 on: November 07, 2022, 08:24:39 PM »


I'm thinking of doing precise 2.2 tibias (maybe 4-5cm) with Dr. Giotikas and then doing nail removal with Dr. Assayag in Baltimore one year later. I heard that nail removal surgery requires about a week of recovery. Where in Baltimore would you stay if you were going to do nail removal surgery?

I have some relatives a few hours drive from Baltimore that I might also be able to stay with but I'm not sure if it is better to stay in Baltimore when recovering from nail removal
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Height Journey

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #132 on: November 08, 2022, 01:24:49 AM »

I'm thinking of doing precise 2.2 tibias (maybe 4-5cm) with Dr. Giotikas and then doing nail removal with Dr. Assayag in Baltimore one year later. I heard that nail removal surgery requires about a week of recovery. Where in Baltimore would you stay if you were going to do nail removal surgery?

I have some relatives a few hours drive from Baltimore that I might also be able to stay with but I'm not sure if it is better to stay in Baltimore when recovering from nail removal

Nail removal recovery is much easier. You only need forearm crutches for 2 weeks at most after nail removal. It would be a good idea to use a shower chair while showering for 2 to 4 weeks after surgery. And just be cautious while walking around for up to 6 weeks after surgery. After 6 weeks you are completely healed and free to go.

Hackerman Patz house is a good option in Baltimore, but room availability is limited. For nail removal surgery, you are fine staying at your relative's house for about 2 weeks.
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3.7cm tibias with Precice 2.2 nails in 2022
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SpeedDialer

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #133 on: November 08, 2022, 06:54:47 PM »

Nail removal recovery is much easier. You only need forearm crutches for 2 weeks at most after nail removal. It would be a good idea to use a shower chair while showering for 2 to 4 weeks after surgery. And just be cautious while walking around for up to 6 weeks after surgery. After 6 weeks you are completely healed and free to go.

Hackerman Patz house is a good option in Baltimore, but room availability is limited. For nail removal surgery, you are fine staying at your relative's house for about 2 weeks.

Thanks!
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Height Journey

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #134 on: November 11, 2022, 12:25:27 AM »

Day 119 – Dorsiflexion Angle Improvements, Accordion Method, +3.7cm (1.46 inch)

https://heightjourney.wordpress.com/2022/11/10/day-119-dorsiflexion-angle-improvements-accordion-method-3-7cm-1-46-inch/
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3.7cm tibias with Precice 2.2 nails in 2022
7.0cm femurs with Precice 2.2 nails in 2021

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liltunechi

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #135 on: November 12, 2022, 02:46:02 AM »

Day 119 – Dorsiflexion Angle Improvements, Accordion Method, +3.7cm (1.46 inch)

https://heightjourney.wordpress.com/2022/11/10/day-119-dorsiflexion-angle-improvements-accordion-method-3-7cm-1-46-inch/

Hello height journey

I noticed in your X-rays that on the left tibia, the syndesmosis screw is inserted horizontally. I have heard Dr Paley speak on the importance of having this screw fixed at an angle (diagonally).

Have you asked Dr Assayag why on one leg it was inserted diagonally and horizontally on the other?

I’d love to know

Thank you and all the best!
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EndGame

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #136 on: November 12, 2022, 01:20:47 PM »

Great content. Thanks HJ. Congrats on further ROM progress
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Height Journey

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #137 on: November 12, 2022, 09:49:39 PM »

Hello height journey

I noticed in your X-rays that on the left tibia, the syndesmosis screw is inserted horizontally. I have heard Dr Paley speak on the importance of having this screw fixed at an angle (diagonally).

Have you asked Dr Assayag why on one leg it was inserted diagonally and horizontally on the other?

I’d love to know

Thank you and all the best!

I watched that Cyborg4Life interview with Dr Paley as well. So far I had not had any problems with the fibula being properly aligned. Everything is going well, so I did not ask him. Perhaps the next time I meet with Dr Assayag I'll ask him about the syndesmosis screws.
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3.7cm tibias with Precice 2.2 nails in 2022
7.0cm femurs with Precice 2.2 nails in 2021

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Height Journey

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #138 on: November 17, 2022, 02:00:54 AM »

Day 125 – Physical Therapy Progress, AlterG, Rollator, Orthofix PhysioStim, +3.7cm (1.46 inch)

https://heightjourney.wordpress.com/2022/11/16/day-125-physical-therapy-progress-alterg-rollator-orthofix-physiostim-3-7cm-1-46-inch/
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3.7cm tibias with Precice 2.2 nails in 2022
7.0cm femurs with Precice 2.2 nails in 2021

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SpeedDialer

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #139 on: November 18, 2022, 02:24:32 PM »

Day 125 – Physical Therapy Progress, AlterG, Rollator, Orthofix PhysioStim, +3.7cm (1.46 inch)

https://heightjourney.wordpress.com/2022/11/16/day-125-physical-therapy-progress-alterg-rollator-orthofix-physiostim-3-7cm-1-46-inch/

https://heightjourney.files.wordpress.com/2022/11/rollator.png?w=430

"Rollator Walker – Also known as a 4 wheel walker with hand brakes. I recently bought and am using the Medline Rollator. Not only is it faster than a regular walker, but it helps out with physical therapy."

Damn, I never thought about this, it looks great and convenient. I'm planning on doing internal tibias in Athens and staying there for 6 months. However, I don't think a 4 wheel walker will play nice with the very run down and uneven pavement in Athens. Do you think its still worth using the rollator walker 6 months after precise tibia surgery? I should be back in the USA by then in a city that is much more friendly for handicapped people

Looks like a good deal for 65 USD
https://www.amazon.com/Medline-Rollator-Rolling-Supports-Burgundy/dp/B079PG3BR3/ref=sr_1_6_mod_primary_new?keywords=Rollator+Walker&qid=1668781538&sbo=RZvfv%2F%2FHxDF%2BO5021pAnSA%3D%3D&sr=8-6&ufe=app_do%3Aamzn1.fos.08f69ac3-fd3d-4b88-bca2-8997e41410bb

"Orthofix PhysioStim Bone Stimulator"

This thing kind of reminds of the exogen or something device they use to talk about in the old forum, though I think that older one might have used ultrasonic or something, not sure
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SpeedDialer

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #140 on: November 18, 2022, 06:29:18 PM »

Thanks for making this video below



In the video above, you mentioned 0.75 mm per day as one possible tibia lengthening rate

What are your thoughts on an even slower rate strategy for precise tibias like 0.5 mm per day for precise tibias? I can't remember exactly but I vaguely recall a girl on this forum saying something about doing it that slow (might not have been 0.5 mm) to prevent ballerina foot, I might be misremembering. My impression is that since tibias heal slower, I wonder if there is more wiggle room to lengthen slower without risking premature consolidation

The reason I ask is that for femurs, I slowed all the way down to about 0.66 mm per day and it made the journey alot easier/more bearable than when I was doing 1mm per day-- so I sort of am curious about the strategies people used for tibias. I do not think I have had premature consolidation on femurs since my bone growth was slow/behind schedule two weeks ago, but I'll have to find out when I see a doctor on Monday.

I'd be willing to pay more to stay in Athens longer to have an easier time for precise tibias if an ultra slow lengthening strategy was realistic. I'm still debating in my mind between staying in the doctor's area for 4 versus 5 versus 6 months to do between 4-5 cm for precise tibias
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Height Journey

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #141 on: November 18, 2022, 07:36:10 PM »

https://heightjourney.files.wordpress.com/2022/11/rollator.png?w=430

"Rollator Walker – Also known as a 4 wheel walker with hand brakes. I recently bought and am using the Medline Rollator. Not only is it faster than a regular walker, but it helps out with physical therapy."

Damn, I never thought about this, it looks great and convenient. I'm planning on doing internal tibias in Athens and staying there for 6 months. However, I don't think a 4 wheel walker will play nice with the very run down and uneven pavement in Athens. Do you think its still worth using the rollator walker 6 months after precise tibia surgery? I should be back in the USA by then in a city that is much more friendly for handicapped people

Looks like a good deal for 65 USD
https://www.amazon.com/Medline-Rollator-Rolling-Supports-Burgundy/dp/B079PG3BR3/ref=sr_1_6_mod_primary_new?keywords=Rollator+Walker&qid=1668781538&sbo=RZvfv%2F%2FHxDF%2BO5021pAnSA%3D%3D&sr=8-6&ufe=app_do%3Aamzn1.fos.08f69ac3-fd3d-4b88-bca2-8997e41410bb

"Orthofix PhysioStim Bone Stimulator"

This thing kind of reminds of the exogen or something device they use to talk about in the old forum, though I think that older one might have used ultrasonic or something, not sure

If after 6 months when you return to the USA, it's probably not necessary if you are allowed to use forearm crutches. But if you're not on forearm crutches by then, a rollator would be helpful.
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3.7cm tibias with Precice 2.2 nails in 2022
7.0cm femurs with Precice 2.2 nails in 2021

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Height Journey

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #142 on: November 18, 2022, 07:41:22 PM »

Thanks for making this video below



In the video above, you mentioned 0.75 mm per day as one possible tibia lengthening rate

What are your thoughts on an even slower rate strategy for precise tibias like 0.5 mm per day for precise tibias? I can't remember exactly but I vaguely recall a girl on this forum saying something about doing it that slow (might not have been 0.5 mm) to prevent ballerina foot, I might be misremembering. My impression is that since tibias heal slower, I wonder if there is more wiggle room to lengthen slower without risking premature consolidation

The reason I ask is that for femurs, I slowed all the way down to about 0.66 mm per day and it made the journey alot easier/more bearable than when I was doing 1mm per day-- so I sort of am curious about the strategies people used for tibias. I do not think I have had premature consolidation on femurs since my bone growth was slow/behind schedule two weeks ago, but I'll have to find out when I see a doctor on Monday.

I'd be willing to pay more to stay in Athens longer to have an easier time for precise tibias if an ultra slow lengthening strategy was realistic. I'm still debating in my mind between staying in the doctor's area for 4 versus 5 versus 6 months to do between 4-5 cm for precise tibias

0.75mm/day is standard for tibia lengthening. I was lengthening 0.75mm/day, but when I reached about 2.5cm I had to slow down to 0.50mm/day. It was a relief for my ankle tightness to slow down.

Lengthen what your body can handle. I know a few tibia patients who lengthened 0.50mm/day much earlier (less than 1cm reached) because their callus formation was slow. And when they got to around 3cm, they had to slow down even more to 0.25mm/day. Everyone has different bodies. Just lengthen what your body can handle.
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3.7cm tibias with Precice 2.2 nails in 2022
7.0cm femurs with Precice 2.2 nails in 2021

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Height Journey

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #143 on: November 28, 2022, 03:20:38 AM »

Day 136 – Physical Therapy Progress, Dorsiflexion Progress, Orthofix PhysioStim, Gym Exercises, +3.7cm (1.46 inch)

https://heightjourney.wordpress.com/2022/11/27/day-136-physical-therapy-progress-dorsiflexion-progress-orthofix-physiostim-gym-exercises-3-7cm-1-46-inch/
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3.7cm tibias with Precice 2.2 nails in 2022
7.0cm femurs with Precice 2.2 nails in 2021

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3.7cm tibias with Precice 2.2 nails in 2022
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Harry1309

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #145 on: December 01, 2022, 05:35:14 PM »

What a great journal, thank you HJ! And Dr Assayag seems like an incredible surgeon too! What is the best way to contact him?
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Height Journey

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #146 on: December 03, 2022, 04:05:02 AM »

Day 141 – Third X-rays in Tibial Consolidation, Height Journey Website, +3.7cm (1.46 inch)

https://heightjourney.wordpress.com/2022/12/02/day-141-third-x-rays-in-tibial-consolidation-height-journey-website-3-7cm-1-46-inch/
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3.7cm tibias with Precice 2.2 nails in 2022
7.0cm femurs with Precice 2.2 nails in 2021

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Height Journey

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #147 on: December 03, 2022, 04:06:05 AM »

What a great journal, thank you HJ! And Dr Assayag seems like an incredible surgeon too! What is the best way to contact him?

The contact info on his website is the best way to contact Dr Assayag.
https://www.heightrx.com/
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3.7cm tibias with Precice 2.2 nails in 2022
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Siegfried

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #148 on: December 04, 2022, 01:48:46 PM »

When do you think you will be completely off crutches?
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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #149 on: December 04, 2022, 10:02:04 PM »

When do you think you will be completely off crutches?

I can walk inside the home without crutches or cane. For longer distances, I think I'll be walking without crutches about 2 weeks (on Dec 16) after my last X-rays.
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3.7cm tibias with Precice 2.2 nails in 2022
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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #150 on: December 08, 2022, 02:45:33 AM »

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3.7cm tibias with Precice 2.2 nails in 2022
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LIVELIFETHEWAYIWANT

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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #151 on: December 08, 2022, 10:23:59 AM »

only 3.7 cm huh ?

i did 8cm on femur , i want to do 5cm on tibia . any suggestions?
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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #152 on: December 09, 2022, 03:17:15 PM »

only 3.7 cm huh ?

i did 8cm on femur , i want to do 5cm on tibia . any suggestions?

As long as your tibia surgery is at least 8 months past your femur surgery, that should be fine. You need the time to stretch and adapt your muscles for the maximum safe length of 5cm tibias.

Here’s my video on preparing for tibial lengthening surgery.
https://youtu.be/nQq4UE_E6Ug
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3.7cm tibias with Precice 2.2 nails in 2022
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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #153 on: December 13, 2022, 03:29:53 AM »

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3.7cm tibias with Precice 2.2 nails in 2022
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Re: Tibia Lengthening (Precice 2.2) with Dr Assayag
« Reply #154 on: December 18, 2022, 01:34:58 AM »

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3.7cm tibias with Precice 2.2 nails in 2022
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