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>> So Ingrid presented with a - a leg deformity called a valgus deformity,
more commonly known as a knock knee deformity.
And it was visible, very visible.
Her leg was crooked and because of that she had developed arthritis in her knee.
A crooked leg is like mal-aligned car.
And just like a car that's not lined up properly it puts more pressure on one side,
and leads to premature wear of the tires.
A crooked leg puts more pressure on one side of the knee joint, and leads to arthritis.
>> I mean I lived with it for a long time and then it got to a point you know
when I got closer to 40 that it just became something that I was aware of constantly,
it didn't matter what I was doing.
If I was biking, or running around, swimming, I couldn't do anything anymore.
I went skiing in Maine because I always had to do something.
I wasn't never going to say I'm not going to do something because my leg hurts or whatever.
So I went skiing, which wasn't the smarted decisions.
And I ended up falling, wiping out down the hill of course.
And hurt my right leg, tore the ACL completely.
So I went into the city to have it repaired, and the guy didn't know which leg I was there
for because I had one sticking out the side, the other one had the ACL was busted.
And he said, "I think I know someone who could help you."
So he sent me over to Ross Brook x-rays.
Ross Brook came back and said, "Great I'll meet her.
I can do it."
And he said, "Not only do you have one bad leg; you have two bad legs.
I need to straighten both of them."
>> She actually had a deformance in both legs.
One was very dramatic.
She had a knock knee on one side, and the bow leg on the other side.
And so we did them in staged fashion.
We did one and then did the other one, so that I was able
to maintain her mobility the whole time.
>> Prior to me going to Ross Brook I had addressed the issue with other doctors
and they wanted to give me a complete and total knee replacement at the age of 40;
you know you really shouldn't be having them at the age of 40.
You ideally want to have - because you can only do it once.
So I had a lot of people want to do a lot of strange things.
We set the osteotomy and he's the only one who kind of had the perfect answer.
So I was like "Sign me up."
I was booked within a month and ready to go.
The best thing I ever did.
>> She was so self-conscious about her leg deformity
that she wouldn't wear shorts or skirts.
And was really ashamed of the way her leg looked.
And that combination of functional problem, inability to walk well; run well,
pain in the knee and an aesthetic displeasure with the appearance.
And a sub consciousness with the crooked leg is very common.
That's a combination that I see.
And this is a situation where you don't want to do a knee replacement.
You want to preserve the knee joint.
My goal is to straighten the leg and by straightening the leg I'm going
to make the knee function better.
So the process is basically to - to cut the bone and realign the leg.
So cutting the bone is something called osteotomy.
It's the fancy word for it.
And the best way to do it and the way that we do it is in a minimally invasive fashion
where we do almost like a partial cut in the bone.
It's a very small cut in the bone, just enough to allow the bone to have some mobility.
And we build a frame on the leg.
Kind of like braces would be on teeth.
And by teaching the patient how to adjust the frame three to four times per day.
Very, very gradually over the course of two, three, four weeks, depending on the size
of the deformity, the leg will straighten out.
So in other words, the bone will just gradually change its position.
And while it's doing that, bone will grow and - and then will hold it in that position.
Now the big advantage of doing it in this kind of way is
that when you do things gradually the body tolerates it very nicely.
And you can - you can correct deformities, we can lengthen,
we can actually pull the bone apart and bone will fill in the gap.
The skin and the muscles and the nerves all stretch very, very slowly and they grow.
So the body kind of deals with it, almost like it's a growth spurt.
We do the surgery under a regional anesthetic, like an epidural.
Very little blood loss during the surgery.
We apply the apparatus to the leg, to match the deformity.
Cut the bone through very small incision, wait a week until the bone starts to heal a little bit.
And then we start the process of gradual straightening.
This is the only way you can do lengthening.
The only way you can actually lengthen the leg is by doing it gradually.
>> Some situations we have the patients do their own adjustments,
and sometimes it doesn't require that.
It really just requires doing a little bit of adjustments here in the office
when they come in every few weeks.
In this situation, we use the frame to actually compress.
Just like you can use these frames to pull the bone apart, slowly to lengthen,
you can also use the frame to actually compress or move it
in this direction, and that's what this frame is.
I mean these are - this is a custom made frame for Arlene, for what her particular needs are.
And it's built like an erector set.
We build it on the patient in the operating room until the [Inaudible].
>> That's what I tell everybody that asks.
"My doctor plays with erector sets."
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>> Oh he's one of the nicest doctors I ever - I've ever had.
And honestly he'll send you an email at 12:00 at night.
He'll call you from - on the - from his own cell phone on the weekends.
He has the nicest bed side manner.
You're never rushed.
You're doing this for - in my situation for almost a year.
And you're in the city every week and you're in the hospital for five days
and you don't want some gruff guy coming in just you know, number 22,
Ingrid, oh what's your last name?
He knows everything about you.
That you have kids, and how you're doing.
I'd do it again in a second.
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>> We're here.
We have excellent predictable, reproducible methods for dealing with these kinds of problem.
A lot of people still don't completely know that this is possible.
People really don't know that it is possible to lengthen a leg to straighten a crooked leg.
And so it's important that people know that we're here.
And that people don't have to live with these problems.
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>> Half of these exercises that you see, I was never able to do.
It's a lot of fun and I feel better about myself.
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