@GoodLegProject
GOOD LEG PROJECT
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2014-2011: Revaluation

With the rejuvenation of my interest, my approach turned from reactive to proactive. I met with the some of the top orthopedic surgeons in California for evaluations. Engaged with the orthotics departments at UCSF and Stanford. Lastly, I've made a concerted effort to explore physical therapy options. The work done on these three fronts has resulted in a dramatic improvement in my functionality.   

2014-10-01 - Bi Lateral CTScan
Uinversity of San Francisco Medical Imaging Center
The first 3D rendering of my entire leg.
Full Leg 3D Render w/ Joint Highlights (click to play)

A video posted by Max Conserva (@goodlegproject) on Sep 14, 2015 at 4:57pm PDT

3D Render of Knee Rotating Around Vertical Axis (click to play)

A video posted by Max Conserva (@goodlegproject) on Sep 23, 2015 at 10:10am PDT

3D Render of Knee Rotating Around Horzontal Axis (click to play)

A video posted by Max Conserva (@goodlegproject) on Sep 24, 2015 at 10:49am PDT


2014-08-19 - Evaluation for Osteotomy Realignment
Dr. Saam Morshed, Dr. Kristina Olson & Dr. Ben Ma - Orthopedic Surgeons - UCSF
_2014-10-07_morshed-olson-ma_ucsf_notes.pdf
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X-Ray Snapshots (Full resolution pdf w/ radiology report available below)
_2014-10-07_morshedolson_ucsf_films_1.pdf
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2013-07-31 - Gait & Motion Analysis Study
Leslie Torburn - Physical Therapist - Lucile Packard Children's Hospital @ Stanford Medical
Upon a recommendation from Gary Berke an orthotist in association with Stanford Medical Hospital I participated in a Gait & Motion Analysis at the Lucile Packard Children's Hospital. I was able to do this via a generous grant from the department. In this study I was evaluated by various devices (EMG, video, infrared motion trackers) to analyze my gait. We reviewed my gait while walking with no orthotics, an AFO only and a full KAFO. What was learned:
  • We discovered the massive amount of muscle exertion required in my glutes to prevent my knee from buckling medially while walking without a KAFO. 
  • The data received has gone toward the development of my current orthotics and will serve as a baseline for future prototypes. 
  • Set a PT target of obtaining 10 degrees of dorsiflexion in ankle and 110 (for stairs) and in my knee to allow for more normal gait
2013-07_report_torburn_lucile_packard.pdf
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 Videos and motion tracking will be posted shorty.
Download Raw Motion Capture Data (CD3 Files) - Need motion capture software to view

2011-12-08 - Evaluation for Knee Reconstruction
Dr. Stuart Goodman - Orthopedic Surgeon - Stanford Medical Hosptial
I sought a consultation with Dr. Goodman at Stanford Medical on the advise of a friend in the field. He came to the same conclusion as the other 3 orthopedic surgeons I had seen recently. In the most optimistic case a reconstructed knee would not yield the same level of functionality as my salvaged limb. Not to mention the level of doubt that I could even receive an artificial device given the depleted and abnormal structure that it would be installed upon. In addition he was of the belief that between he and Micheal Reis at UCSF (which I had already consulted with), I had seen the best minds in California on the subject. He is confident that there are no viable surgical option available for me needs at this time given my specifics. And that the only reason for his opinion to change would be if my pain dramatically increased or some new technology became available.
notes_goodman_stanford_medical.pdf
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X-Ray Snapshots (Full resolution pdf w/ radiology report available below)
x-ray_goodman_stanford_medical.pdf
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2011-11-08 - Evaluation for Knee Reconstruction
Dr. Kevin Louie - Orthopedic Surgeon - California Pacific Orthotic & Sports Medicine (CPOSM)
I had a consultation with Kevin Louie for expertise in limb salvage cases. His immediate advice was that given my current level of activity, knee reconstruction had nothing to offer beyond pain management if that ever became an issue. Neither an artificial knee nor a bone allograft of some kind. I had seen Dr. Louie in 2007 where he was of a similar opinion.
Medical notes to be posted shortly

2011-09-30 - CT Scan @ 35 degree bend
California Pacific Orthotic & Sports Medicine (CPOSM)
To learn a little more about the movement of my leg I got the idea of getting a CT Scan 3D rendering of my knee to see what it would look like while in flexion. Unfortunately the most flexion we could do and still fit in the machine was about 35 degrees. However even at 35 degrees you can see the abnormal movement. The direction of motion becomes more clear when comparing it to the scans of my knee in extension in 2006. The femur, rather then rolling back on the tibia, simply falls into the massive structural hole that would normally be the lateral compartment. I am thinking of putting together a side-by-side comparison of the knee from each view point in extension and @ 35 degrees. So much to do...
CT Scan Snapshots (Full resolution pdf w/ radiology report available below)
2011-09_ct_scan_images_cposm.pdf
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2011-09-28 - Evaluation for Knee Reconstruction
Dr. Michael Reis - Chief of Arthroplasty - University of California at San Francisco Medical Center
I was recommended to see Micheal Reis as one of the top anthroplasty surgeons in California. Micheal Reis was of the following opinion on knee reconstrction:
  • Knee replacement would be complex because of the lack of material. Because there are no ligaments on lateral side we would need to do a hinged joint replacement. Which has limited functionality
  • Positive aspects of a knee replacement would be increased stability, probable increased flexion (depends on how much the muscles would do after having not stretched in so long), and valgus correction. 
  • However given the level of activity in which I currently engaged a reconstruction would not be functionally sufficient and it's longevity in such a situation would be questionable.
2011-09-28_michael_reis_ucsf.pdf
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2011-09-26 - Evaluation for Knee Reconstruction
Dr. William Green - Orthopedic Surgeon - California Pacific Orthotic & Sports Medicine (CPOSM)
To be evaluated for surgical options the first doctor I attempted to see was Dr. Bost at CPOSM whom I had seen a couple of times in the mid 2000s when I strained my knee snowboarding. Unfortunately Dr. Bost had retired by 2011 so I was directed to Dr. Green. Dr. Green, was frank in saying that he was not the man for my type of knee reconstruction. Given my level of activity/functionality he doubted a reconstruction would be a step in the right direction at this point. He directed me to Dr. Kevin Louie, an expert of knee salvages, for another opinion.
110926_-_cposm_dr_green_-_consultation.pdf
File Size: 318 kb
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X-Ray Snapshots (Full resolution pdf w/ radiology report available below)
110926_-_cposm_dr_green_x-rays_and_report.pdf
File Size: 1431 kb
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