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Author Topic: Knock knees when overlengthening femurs with LON  (Read 1101 times)

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AnotherLLer

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Knock knees when overlengthening femurs with LON
« on: August 03, 2024, 07:58:56 PM »

Is it true that after certain cms of distraction bones start to bent and the risk of getting axis deviation increase? If true, after what amount of cms it starts to become a significant risk? 5 cm? 6.5 cm?

If one wants to lengthen 8 cm for example and during the distraction phase bones bent, won't the surgeon be able to correct them during the external frame removal surgery before locking in the screws?

If the correction is not possible, it means that most people who do 7 or more cms on femur with LON get knock knees which sound kinda unrealistic as there would have been tons of patients who would complain about that issue.
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wes07

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Re: Knock knees when overlengthening femurs with LON
« Reply #1 on: August 03, 2024, 08:07:30 PM »

Hey bro, where are you getting all this info from? I'm also thinking about LON femur and I want to learn about all the potential complications.
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AnotherLLer

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Re: Knock knees when overlengthening femurs with LON
« Reply #2 on: August 03, 2024, 08:36:33 PM »

I've read this on this forum numerous times. IDK where they got this info but it seems logical since more you distract, the more it can bent and I've seen in Meck's diary that he got bent frames due to overlengthening but got corrected during the frame removal and nail locking surgery. If it can be corrected, I see no issue whatsoever if during the distraction phase femurs get bent a bit. What matters is final consolidation of bones and their position.
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Beemer m3

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Re: Knock knees when overlengthening femurs with LON
« Reply #3 on: August 05, 2024, 07:28:53 AM »

i notice grls already have knees bending in and when they lengthen even more u can visibly see it. but will eventually go back to  position.
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before 168cm current 173.5 cm
ilizarov tibia
sept 2023

goal 2025-26 precice max femur

AnotherLLer

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Re: Knock knees when overlengthening femurs with LON
« Reply #4 on: August 05, 2024, 08:08:11 AM »

I kinda want to overlengthen my femurs for one: significant height increase; two: get visibly longer femurs in order to get long and streamlined legs and three: increase my stride length (femur length is responsible for stride length the most).

By overlengthening I mean no more than 9 cm and no less than 7.5 cm. Ovelengthening is above 6.5 cm for femur and above 5 cm for tibia.

Since I'm going to do the tibia after the femur, even if I lengthen 9 cm on my femurs, it won't be an issue.

If I wanted to do only femurs, I would never go past 6.5 cm since above that looks really bad with short tibia. Above 6.5 cm on femurs only makes sense when you're going to lengthen the tibia too in order to restore the biomechanics and proportions between the leg segments.

That's why I'm worried about possible misalignment issues that might arise with the LON femur after about 6.5 cm. I know that it gets way harder after 5 cm and every cm is a challenge to achieve past that amount but LL is a challenge itself so you have to have Meck's mindset to win this challenge, otherwise, complaining and regretting of why are you doing this will make you lose this challenge.

I've read many diaries here and some people whined and regretted during the process and wanted to quit as soon as possible. Some even said that had they known the pain and challenges it brings, they would never do this in the first place which is not strong-minded and shows that LL is not for everyone.
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throwaway123456

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Re: Knock knees when overlengthening femurs with LON
« Reply #5 on: August 06, 2024, 02:14:29 AM »

I am male with narrow hips (low Q Angle). I did 8cm internals on femurs (through knees), I still am stiff/sore after 6 years in my knees/distal thigh.
However at least I have no evidence of knock knee , I have ~ 1 cm gap between knees when standing with ankles touching.
If I were female and if the rods were inserted through my hips I would think knock knee would be likely.
Yes, last 2-3 cm of 8cm is pretty tough for the soft tissue in your femurs and ability to ben/extend knees, I had to progressively drop daily rate of LL to 0.8mm, 0.6, 0.5, 0.3 in the last ~5 weeks of my CLL.
And I do agree your Tibs can look shorter after femur CLL 8cm,  my T/F ratio was ~0.8 before CLL, and now at ~0.7, I look ok in long pants and I do tend to use ~ 2 cm build up in my shoe which helps, longer shorts are ok (ish), but I avoid being seen in short shorts.
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1team

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Re: Knock knees when overlengthening femurs with LON
« Reply #6 on: August 06, 2024, 02:43:50 AM »

I am male with narrow hips (low Q Angle). I did 8cm internals on femurs (through knees), I still am stiff/sore after 6 years in my knees/distal thigh.
However at least I have no evidence of knock knee , I have ~ 1 cm gap between knees when standing with ankles touching.
If I were female and if the rods were inserted through my hips I would think knock knee would be likely.
Yes, last 2-3 cm of 8cm is pretty tough for the soft tissue in your femurs and ability to ben/extend knees, I had to progressively drop daily rate of LL to 0.8mm, 0.6, 0.5, 0.3 in the last ~5 weeks of my CLL.
And I do agree your Tibs can look shorter after femur CLL 8cm,  my T/F ratio was ~0.8 before CLL, and now at ~0.7, I look ok in long pants and I do tend to use ~ 2 cm build up in my shoe which helps, longer shorts are ok (ish), but I avoid being seen in short shorts.

It's those last few cm lengthening where all the permanent damage occurs. People say stretching helps but because the effects of stretching diminish very quickly as soon as you stop it just masks when lengtheners reach their physical limits. Did you get an MRI to confirm it wasn't any other issues and the stiffness/soreness is just from the lengthening?

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wes07

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Re: Knock knees when overlengthening femurs with LON
« Reply #7 on: August 06, 2024, 02:55:04 AM »

do you thin 6cm femur is the best and safest for CLL in terms of athleticism and recovery? or would you say 5.5cm? will the benefits of stretching diminish one I hit those numbers?
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1team

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Re: Knock knees when overlengthening femurs with LON
« Reply #8 on: August 06, 2024, 04:40:29 AM »

do you thin 6cm femur is the best and safest for CLL in terms of athleticism and recovery? or would you say 5.5cm? will the benefits of stretching diminish one I hit those numbers?

What is your starting height? Taller patients can lengthen more and with better permanent recovery compared to shorter ones doing a similar amount.
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DanishViking

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Re: Knock knees when overlengthening femurs with LON
« Reply #9 on: August 06, 2024, 10:08:40 AM »

Lon femur lengthening is in generel not advised for the following reasons:

1. Much higher risk of infection and deep infection, that can cause amputation, if not treated correctly at the worst.

2. The pain according to many earlier patients is absolutely terrible, especially compared to precice

3. You have metal rods trough your muscles that can give you less range of motion permanently.
 (Femurs)

However it is much cheaper, but when it comes to your health, money doesn't matter if you can't function properly.

4.
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AnotherLLer

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Re: Knock knees when overlengthening femurs with LON
« Reply #10 on: August 06, 2024, 10:20:35 AM »

I won't be able to afford PMax and PRECICE 2 is torture mentally as you're wheelchair bound for 5 months.

I can risk LON femur for 5 or 6.5 cm (and then lengthen the tibia for 4 or 5.2 cm, respectively). So, in total, I can gain at least 9 cm or 11.7 cm, both of which is very noticeable height increase and my proportions will improve a lot.

8 cm is kinda too much with LON since it gets much harder after 5 cm but 6.5 cm is realistic goal IMO and after that 5.2 cm on tibia is also realistic goal to not get crippled.

Recovery is very important to me but also I want to gain significant height from both procedures so 6.5 cm on femur and 5.2 cm on tibia is half a head in total at 11.7 cm, which is significant height increase and worth it 100%.

5 cm on femur and 4 cm on tibia is the least amount I'd do, below that is not worth it IMO. But, 6.5 cm on femur and 5.2 cm on tibia is the golden point between conservative and risky amounts and that additional 2.7 cm is still something versus 9 cm since every cm is important from 165 to 178 cm and 2.7 cm is significant height since you can gain that much with 2 inch lifts relative to others, which is significant.
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DanishViking

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Re: Knock knees when overlengthening femurs with LON
« Reply #11 on: August 06, 2024, 11:26:42 AM »

I do agree with your points. However I would skip LON since the complication rate is to high and for the reasons stated above, unless you're willing to take a decent risk.

If you don't whey much, you could potentially be able to walk after  the lengthening fase, if your're strong enough. However that is the best case scenario.
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AnotherLLer

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Re: Knock knees when overlengthening femurs with LON
« Reply #12 on: August 06, 2024, 11:34:58 AM »

I do agree with your points. However I would skip LON since the complication rate is to high and for the reasons stated above, unless you're willing to take a decent risk.

If you don't whey much, you could potentially be able to walk after  the lengthening fase, if your're strong enough. However that is the best case scenario.

Unfortunately, I won't be able to afford PMax and doing just tibia is not enough for my bad starting height and short legs.

I weigh about 70 kg at 165 cm so it's not an issue.

I have muscular thighs and I'm worried about that though. It will be painful doing LON on muscular thighs it seems.

Anyways, I need to get decent amount of height from double LL and since most height comes from femur, I have to push it for at least 6.5 cm or even 8 cm and then lengthen tibia by 5 or 5.5 cm max. That way I can gain at least 11.5 cm or at most 13.5 cm total height, which is worth the struggle and most importantly, I will look fine even if I do 13.5 cm since my legs are comically short for my torso right now.
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