No worries and thanks a lot for the detailed info! I've decided I'll only lengthen my tibias and although I'd love 6 or 7 cms, it seems stopping at 5cm is the safe option.
Fast recovery is my top priority and I'll compromise potential height gain for it (I'll do only tibias and only 5cm). So GNail/Betzbone looks like the right method for me. But I see Precise is an even more expensive method. What's the real advantage to choosing Precise over GNail/Betzbone?
Also, although I'll read some diaries soon, how much longer is the recovery with non weight bearing nails compared to weight bearing nails on average?
Thanks
TLDR: If I were you and if I was hellbent on only doing tibias, I'd do 5-6cm weight bearing clicking tibias with either Becker or Jean-Marc Guichet
Also sorry about my confusing message earlier-- Precise is actually less expensive than gnail/betzbone. Ex: there are patients here in Athens now who did precise and they paid less than what I paid for gnail. It is actually the USA and Paley that are expensive
The issue with Paley / USA doctors is that 1) they don't have access to gnail/betzbone 2) so they use precise 3) USA doctors are expensive, though I heard Dr. Assayag and Mahoubian are less expensive than Paley
So basically it's like:
USA is most expensive (because in the USA healthcare is often expensive in general) and they use precise
France / Germany / Milan italy/ London are also expensive but they have access to gnail/betzbone depending on the doctor and they also have access to precise. Gnail/Betzbone are somewhat more expensive than precise but gnail/betzbone have weight bearing (so you can use crutches much earlier)
Greece is less expensive than the options above but the city of Athens, Greece itself is not wheelchair friendly. Greece has gnail and precise
India with Dr. Parihar is possibly worth considering for people on a budget or are familiar with living in India, he uses precise
Precise has this advantage: no clicking pain, ability to reverse lengthening if something goes wrong. However, I did significantly less than 8cm femurs anyway so I did not care about reversing lengthening because I felt I would not get into this kind of trouble
For weight bearing vs non weigh bearing nails, here are some datapoints I know from Athens:
- I know of two patients who did femur surgery at the same time, but one did precise and one did gnail. At the 5 month mark, the gnail patient can almost walk normally. The other guy who did precise is still on wheelchair at 5 months
- However, this is not always the case! Another datapoint: a girl who was very lightweight who did precise femur and also walk almost normally at the 5 month mark. A very nice recovery, though she only did 4 cm
- Another example: a very very slim guy 5'9 starting height who was like 120 pounds or less who did the 4 precise nail option and was able somehow to use crutches at 4 months, very fast recovery compared to some other patients who had 4 nails in them
Buuuuuut. I will say this. If you know that you will only do tibias, then I highly highly recommend you go with Becker in Germany or Jean-Marc Guichet (france, london, Milan).
Why?
Becker and Jean-Marc Guichet both have weight bearing tibia nails. Your experience will be alot more comfortable if you can use crutches earlier for tibias (you can put your entire body weight on your lower legs to stretch them, this makes training easier just physically). I think it is reasonable to go for 6cm and maybe some people even slightly more with this method, it is easier to stretch the calves if you can stand up.
Although they are more expensive than the option in Greece, it will be much easier for you to continue working if you are not stuck in a wheelchair --- so you can make more money to offset the cost. I still personally would not go above 5cm tibias because Paley would not allow his patients to go above 5 cm tibias even when the weight bearing STRYDE was available in the USA ---but I admit it is completely debatable and I could be wrong.
I think most likely you will end up fine with 6cm tibias with a weight bearing tibia option and it is true that there are plenty of people who do a bit more and end up OK. Not guaranteed to be OK (see some older posts of people who did 7.5 cm+ tibias and they wish they did less) but it is true that there are some people who did 7cm+ tibias and ended up OK.