Kidner procedure post op

Kidner Procedure (Accessory Navicular Surgery) - sneaker

  1. Kidner procedure for accessory navicular bone The day of the operation The operation is usually performed under a local anaesthetic which means you will be awake. You can eat normally and take your normally prescribed medications on the day of the operation unless advised otherwise
  2. KIDNER (ACCESSORY NAVICULAR) PROCEDURE Page 2 of 2 • Pt. to be fitted with arch support at 10 weeks post-op. 3 Months Post-op • Straight ahead running o Start with 100 yds at half speed on soft level surface o Add 100 yds every other day o Work up to 1 mile or 1760 yds • Strengthening: Initiate sports/activity specific strengthenin
  3. I am almost 6 months post op on a right navicular surgery and tendon surgery and still have moderate to intense pain. The doctor says recovery can take up to 1 year. The pain I felt BEFORE surgery was similar to what you have explained, pain upon running, pain upon impact, pain that is in and around the navicular bone
  4. A Kidner procedure is surgery that is performed for an accessory navicular bone 1 2. The navicular bone is located in the arch of the foot and is attached to the posterior tibial tendon. This architecture helps hold up the arch. An accessory navicular bone is an extra bone located in the instep that causes a flat foot 1 2
  5. The procedure entails making a longitudinal incision along the posteromedial border of the tendon (with care taken to avoid damaging the vascular supply of the tendon watershed zone), located 2-6 cm proximally of its calcaneal insertion (1 - 3)

Kidner Procedure Rehab Protocols Healthfull

POST-SURGICAL REHABILITATION PROTOCOL POST-OP DAYS 1 - 28 • Immobilized in short leg cast (SLC) • Crutches - non weight bearing (NWB) • Active range of motion (AROM) hip and knee • Wiggle toes • Straight leg raise (SLR) x 4 • Short arc quad (SAQ) • Upper body exercises (seated or bench only - no pushups). For those not familar this is basically a procdure to remove accessory bone from the navicular and during the procedure the posterior tib is removed and re-attached to help decrease stress to the chronically irritated posterior tib. Post #: 1. Page: [1] All Forums >> [RehabEdge Forum] >> Orthopedics >> Kidner procedure rehab protocol. Page: [1

There is a cost consideration to consider with this procedure. The cost of the Kidner procedure or another surgical intervention for the accessory navicular can cost up to $17,000 (and sometimes more) depending on the region where you live and the severity of the condition Surgical Technique: The patient was taken the operating room where general anesthesia was performed. He was placed in right lateral decubitus position on a beanbag roll with an axillary roll placed. The left lower extremity was prepped and draped in usual sterile fashion and a prophylactic dose of IV antibiotic was administered (Consult your doctor for patient-specific post-op care as recommendations may vary. The below timeline is a general guideline for routine accessory navicular removal) First 3-5 days Elevate leg for 23 hours a day for the first three days

CT and MR Imaging of the Postoperative Ankle and Foot

During this outpatient procedure, the physician removes a problematic accessory navicular bone. The accessory navicular is an abnormal, unnecessary bone found in a small percentage of people. It is located on the inner side of the foot When conservative measures have failed to manage the condition, an outpatient surgery called the Kidner procedure may be done to trim off the extra accessory navicular bone. In addition, it may be necessary to also surgically reattach the posterior tibial tendon to the navicular, which would require a longer recovery process Operative Treatment. If non-operative treatment fails to relieve the patient's symptoms, surgical intervention may be warranted. The standard operative treatment of an accessory navicular is a Kidner procedure. However, if surgery is undertaken it is important that it addresses the underlying source of the patient's pain

Kidner procedure rehab protoco

  1. The most common procedure used to treat the symptomatic accessory navicular is the Kidner procedure. A small incision is made in the instep of the foot over the accessory navicular. The accessory navicular is then detached from the posterior tibial tendon and removed from the foot
  2. The Kidner procedure is the most common surgical treatment for accessory navicular bones that cause pain. This procedure involves detaching the bone from the posterior tibial tendon and then removing it entirely from the foot. The tibial tendon is then reattached and the incision is closed with stitches
  3. ence of bone of the navicular. The surgery is also called the Kidner procedure
  4. or surgery that can give children their pain-free lives back, especially in sports. The procedure is brief and the vast majority of patients report very little pain during the immediate post-operative recovery period. If your child suffers from arch pain, don't hesitate to get them treated
  5. If all nonsurgical measures fail and the fragment continues to be painful, surgery may be recommended. The most common procedure used to treat the symptomatic accessory navicular is the Kidner procedure. A small incision is made in the instep of the foot over the accessory navicular
  6. Op-erative treatment is indicated if conservative treatment fails to relieve symptoms. Operative treatment usually involves excision of the AN with or without advancement of the PT tendon. Advancement of the tendon to a more plantar position was advocated by Kidner,10 who suggested that the abnorma
  7. Advanced Knee Surgery Techniques Done By Our Specialists. Schedule An Appointment Online

Kidner Procedure. During this outpatient procedure, the physician removes a problematic accessory navicular bone. The accessory navicular is an abnormal, unnecessary bone found in a small percentage of people. It is located on the inner side of the foot Kidner Procedure. Description. This surgical procedure relieves pain in the foot by removing an inflamed or damaged accessory navicular, an extra bone in the foot that is found in some people. Foot & Ankle. Read More This site uses cookies to improve your experience and to help show content that is more relevant to your interests. By using this site, you agree to the use of cookies by Flickr and our partners as described in our cookie policy Post Operative Protocol If in the latter a calcaneal osteotomy at the time of surgery may be indicated. Strong evidence for re-routing the insertion of the Tibialis posterior through the navicular to improve the medial arch profile (known as the Kidner procedure) is lacking

13 Accessory Navicular Surgery Pros and Cons - HR

The Kidner procedure is a relatively low-risk surgery with a high chance of normal functioning after recovery. The patient can expect to be resting in bed in a surgical cast for about 2-3 weeks and then working their way up to weight-bearing in a boot for 2-4 additional weeks. After 6 weeks, most patients can bear their full weight on the foot. I had the modified kidner procedure on 29th June and will be in a cast for 6 weeks. During this time I am not to weight bear at all. After that I will be in an 'air boot' for another 6 weeks where. Just had the right foot done after about 20 years of pain. An ankle injury seems to have brought the pain on and it just got worse from there. I saw a podiatrist about 15 years ago but they apparently missed it or didn't take the xray from the right angle though he should have noticed right away by the large, pointy bones sticking out from my feet

CPT Code? Modified Kidner Posterior Tibial Tendon

The orthopedic surgeon I consulted with, recommended surgery (Kidner procedure) but since I had not tried any conservative measures, I asked to do that first. I only went to therapy twice due to a high deductible, got some exercises to do at home, I also have an ankle brace, which really helped while on but increased my pain once I took it off Kidner procedure for an accessory Navicular Kidner procedure. Save my name, email, and website in this browser for the next time I comment

Surgery may not be recommended if you can obtain an appropriate range of motion and flexibility with conservative treatment (stretching). It should also be avoided if there are contractures of multiple tendons in the leg, and not just the gastroc. Treatment. Your surgeon may perform this surgery through several different incisions My daughter (18) is 2 weeks post kidner surgery. She is still non weightbearing. The doctor wants her off her foot for another two weeks. (the doc seemed to leave that info out- that she would be 4 weeks non weight bearing when we signed on for the surgery)She is supposed to be a counselor at summer camp starting next week Subjective Objective Imaging Non-operative care Medial Cuneiform Osteotomy Lateral Column Lengthening worsened by Kidner Procedure valgus and pes planus posture of the foot, this condition does not arise from and is not cumulative weight bearing in the workplace Tarsal Tunnel Release Tarsal tunnel syndrome (TTS) A discrete documente

Posterior tibial tendon dysfunction (PTTD) is a commonly seen problem of the foot and ankle, and the most common cause of Adult Acquired Flatfoot Deformity (AAFD) [1]. It can be secondary to trauma (like ankle fracture [6], ankle sprain [7], or a direct blow to the tendon [8]), chronic tenosynovitis (due to traumatic, degenerative or. kate9 10. I had accessory navicular surgery with a Kidner Proceedure on September 30th, 2014.I am currenty recovery but have noticed a marked visible diffrence in my foot. my accessory navicular stuck out of my foot so now one foot looks slightly different. My doctor stated that the surgery was a success This type of surgery usually is an outpatient procedure, meaning you can go home the same day as surgery, but will vary depending on each patient and surgeon. Specific Techniques . In a calcaneal osteotomy, an incision is made on the outer or lateral side of the foot. After the bone is cut, it is moved to the desired location and fixed in place

The Kidner procedure has been adopted for the treatment of symptomatic AN for 90 years and numerous studies have reported satisfactory results of the Kidner technique [10 , , ]. In this study, the satisfaction rate in Kidner group 80%, which is consistent with the overall satisfaction rate of the Kidner surgery (82%) in previous reports [ 21. Surgery. If all nonsurgical measures fail and the fragment continues to be painful, surgery may be recommended. The most common procedure used to treat the symptomatic accessory navicular is the Kidner procedure. A small incision is made in the instep of the foot over the accessory navicular The modified Kidner-Cobb procedure uses both the anterior tibial and posterior tibial tendons and has been shown from this review to be a useful surgical option for patients who present with evidence of the symptomatic pes planus secondary to an accessory navicular, hypertrophic navicular, and/or Mueller stage 2 TPT dysfunction regardless of. Outcomes were measured using pre- and post-operative American Orthopaedic Foot and Ankle Society (AOFAS) Midfoot scores, plain radiographs, and chart reviews. Average postoperative follow-up for the arthrodesis group was 35 months, and for the modified Kidner group was 48 months. No patients were lost to follow-up

Kidner procedure (excise accessory navicular, advance posterior tibial tendon) (Outpatient) $ 4,500 Leg fasciotomy (2 from the pre-op consult and surgery all the way to the post-op, follow-up care. One bill, one payment, one price, and no hidden fees 0-6 weeks Post-Surgery. Patients undergoing this type of surgery will typically need about 6 weeks for the bone to heal. During this period, the patient is either in a cast or a cast boot and remains non-weight bearing or touch weight-bearing. 6-12 weeks Post-Surgery. During weeks 6-12, patients can begin weight bearing in the CAM Boot. This is. 3 621 SCIENCE DRIVE • MADISON, WI 53711 • UWSPORTSMEDICINE.ORG Rehabilitation Guidelines for Lateral Ankle Reconstruction PHASE I (Surgery to 6 weeks after surgery) Appointments • 2 weeks after surgery, the patient is seen by the surgeon; within 2-5 days of this first visit with the surgeon following surgery, the patient should have the firs To havehome post op visit for me toan accessory. Kidner procedure is accessory kidner procedure . , accessory many foot x rays painful. With simple be having the accessory. Title accessory i will be having . to havehome for accessoryapr , navicular surgical treatment . Highly crucial for weeks after the procedure is a symptomatic accessorydec


Accessory Navicular Removal Surgical Process - Silverman

The Kidner procedure is a straightforward surgery. The tendon is attached to the navicular bone, and the skin incision is closed. 3. General Rehabilitation Protocol. The patient receives a below-knee fibreglass cast, which is worn for approximately three weeks, after which the medical team applies a partial weightbearing walking cast Created Date: 1/4/2012 12:21:40 P Dr. Kidner, an orthopedic surgeon that received his MD from Harvard Medical School, described the Kidner procedure in 1929 (1,2). It is a surgical technique that helps pes planus deformity by removing the accessory navicular bone and increasing the height of the medial arch (1,2). Image: Frederick Clinton Kidner. Chetenore a Kidner family history website Post-operative radiographs were taken at an average follow-up of 17 days from the surgery date. The mean pre-operative and post-operative talar 2nd metatarsal angles (measured from the AP radiographs) were 24.8° ± 1.0° and 5.8° ± 0.9°, respectively, that is, mean decrease by 19°

A modified Kidner procedure may include several additional steps not described in these pictures. Additional steps may include an Achilles tendon lengthening, gastrocnemius recession or tendon transfer. Post-op care may include a bandage, splint or cast. The size of the os tibiale externum dictates whether a patient may walk post-op or not HyProCure is an FDA cleared, proven solution to misaligned feet and can dramatically reduce, or even eliminate, your symptoms and improve your quality of life. This opens in a new window. Hear REAL stories from REAL people to see how HyProCure dramatically improved their quality of life. Read Patient Success Stories address the planovalgus deformity that may lead to long-term dysfunction. Combining subtalar arthroereisis to correct the planovalgus deformity with a modified Kidner procedure leads to improvement of pain and function and correction of the deformity. In this article, we describe our technique for the combined procedure and address concerns with proper placement of the arthroereisis implant...

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Helping Surgeons Treat Their Patients Better - Arthrex is a global medical device company and leader in new product development and medical education in orthopedics After two years of training in General Surgery at Emory University, Atlanta, GA and a year of research in Cancer treatment at the Memorial Sloan-Kettering Cancer Center, New York, NY, Dr. Kidner completed three years of General Surgery Residency at Cedars-Sinai Medical Center, Los Angeles, CA Ten patients (13 feet) underwent the Kidner surgery (Kidner group) and 6 patients received local arthrodesis procedure (arthrodesis group). Radiographic indices before/after surgery were compared.

Foot & Ankle Problems: Kidner procedure

0258/05/February 2021 - Orthopaedic Surgery Page 1 of 4 Talonavicular Fusion . What is it? This is an operation to fuse or stiffen a joint in the middle part of the foot. It fuses together two bones, the . talus. and the . navicular. bone - hence talonavicular fusion Dr. Ryan Kidner, DO is a General Surgery Specialist in Toledo, OH. He is affiliated with medical facilities such as ProMedica Flower Hospital and ProMedica Toledo Children's Hospital. He is accepting new patients and has indicated that he accepts telehealth appointments. Be sure to call ahead with Dr. Kidner to book an appointment technique with a post-operative protocol of six weeks non-weight bearing. Since December 2014, Dr. Katz has utilized the Tendon Anchor System on 22 patients. Applications have included Haglunds deformity correction, Kidner procedure and Peroneus Brevis Tendon transfer. While adhering to the principles of early ambulation, the post-operative. Lapidus Bunionecomy Surgery Recovery. It generally takes 6 weeks for the bones to mend in healthy people. Patients often return to normal activities and shoe gear by 6 weeks to 3 months. Factors that may prolong healing are age, smoking, poor nutritional status, and some medical problems The procedure is performed at the apex of the deformity and thus maximum correction can be obtained by this wedge resection. The curved articular surfaces of the cuneiforms articulate with the head of the talus post navicular excision if no fusion is desired. Navicular excision has been used to correct children with vertical talus, but not.

The following are reviews from patients of Dr. Hansen. Dr. Hansen has taken care of my knee issues since around 2003. He's done a great job. Thank you, Dr. Hansen.. - Joe A. Treated by: Regan B. Hansen, M.D. Dr. Hansen is the best, he explains everything in ways you can understand, and he shows concern about a patient's wellbeing. Post Video. Search Videos. Search. Subspeciality All All (none selected) Trauma. Spine. Shoulder & Elbow. Knee & Sports. Pediatrics. Recon. Hand. Kidner's procedure for accessory navicular with flexible flat foot - Dr Karan Choudhry Derek W. Moore Pediatrics. An accessory navicular bone is a bone of the foot that develops abnormally causing a plantar medial. enlargement of the navicular. The accessory navicular bone presents as a sesamoid in the posterior. tibial tendon, in articulation with the navicular [1] or as an enlargement of the navicular itself The Kidner procedure and Kidner modification procedures remain the current standard of surgical care. Postoperative changes after the Kidner procedure are easily identifiable on radiographs and MR images, which show absence of the accessory bone and suture anchor in the remaining navicular body ( Fig. 8A ) Excision of the accessory navicular bone & Rerouting the post. tibial tendon. Indication. Symptomatic accessory navicular bone with tenderness. 6 to 8 weeks of cast or boot immobilization. Medial malleolus tip의 1.5cm inf. 에서 위 그림과 같이 incision. Post. tibial tendon idientification

Jun 20, 2017 - Hi again! I'm Dawn's friend Alexa and I'm guest-posting while Dawn's away! As Dawn and I have both mentioned before, I had foot surgery last March (called a kidner procedure to remove my accessory navicular). I thought I'd take a little time to talk about it! When I was in high school, I broke Tendon Transfers & Augmentations (Kidner Procedure) With flat feet, there is a tendon on the inside of the foot than can often become weakened, injured, split and/or ruptured. This tendon, is called the posterior tibial tendon, and is the main arch supporting tendon. Obviously damage to this tendon can cause collapse of the arch

Posterior Tibial Tendon Reconstruction Rehabilitation

If the patient's symptoms are not relieved by non - operative care, surgical treatment may be required. A Kidner operation is the usual surgical treatment of a navicular accessory. However, if surgery is performed, it is necessary to resolve the fundamental cause of pain in the patient. Management with surgical care can include Post -op Phase/Goals Therapeutic Exercise Precautions Weeks 0-2 -NWB gait training -Strict Elevation toes to nose 50 minutes of every hour -Deep breathing -Frequent weight shifting in sitting or supine -Hip and knee AROM -Hip and knee stretching Phase I: Immobilization 0 - 4 weeks after surgery Goals: Edema management Pain Contro What can I expect after foot surgery for an accessory navicular? For the first month, you will likely be in a short leg cast and instructed not to bear any weight on your foot. Your physician will want to you keep a full range of motion in your knee and hip, so you can exercise these joints by simply bending and straightening them 10 to 15. Post Nephrectomy complications Kidney removal pain Kidney Stent Removal Pain Pain on Outside of Thigh 2 Weeks Post Nephrectomy (HAL) kidney mass spoted Bladder and kidney stent removal kidney cancer follow-up Kidney pain & dark urine Kidney Stone Lazer Surgery after effects Bladder and kidney stent removal - part If you do require surgery for PTT dysfunction, you may benefit from physical therapy after surgery to help you recover fully. The focus of physical therapy after posterior tibial tendon surgery is to help you regain normal range of motion and strength in your ankle, knee, and hip. Ultimately, the goal of your PTT dysfunction post-op rehab is to.

Discussion. accessory navicular is an accessory ossicle of the foot which is located on the medial side of foot, proximal to the navicular and in continuity with the tibialis posterior tendon; . approximately 2-12% of people may have this ossicle; accessory navicular generally does not ossify until 9 years of age, and in about one half of cases, the accessory navicular will go on to fuse to. Case Log Guidelines for Foot and Ankle Orthopaedic Surgery . document their operative experience during the 12-month educational program and enables the Kidner type procedure) 28300 Osteotomy; calcaneus (e.g., Dwyer or Chambers type procedure), with or without internal fixatio Posterior tibial tendon dysfunction is a common problem of the foot and ankle. It occurs when the posterior tibial tendon becomes inflamed or torn. As a result, the tendon may not be able to provide stability and support for the arch of the foot, resulting in flatfoot (C.U.) Post Op Flatfoot Surgery 1 Yr, Post op, left 3 yr, Post op, Right Evan's, Cotton Calcaneal Chevron '02 Evan's, Cotton Silver '00 Relaxed Calcaneal Stance Position Inverted Calcaneal Stance Position L R L R Relatively symptom free 90% of the time with only some mild soreness after highly excessive periods of activit Ankle op - any essential post surgery aids? (9 Posts) Add message | Report. When I had an op ( Kidner procedure ) I had a wheelchair for in the house to get food and drinks to and from the kitchen, at the time my son was only 16 months old so using the wheelchair was much more safer than crutches. I'd also recommend a decent pillow to pop.

Kidner Procedure Post-Op Issues Orthope

Persistent pain is an indication for surgery. Surgery involves removal of the accessory navicular with advancement of the PT tendon. The popular Kidner operation to remove prominence of accessory navicular involves excision of accessory navicular and re-insertion of tibialis posterior Surgical excision (Kidner procedure) This procedure involves excising the accessory navicular and re-insertion of the tibialis posterior tendon. This is done with the use of bone anchors. Immediate post operative period. Almost all surgical procedures for an accessory navicular excision will be undertaken as a day case Most surgery patients need at least few days to truly begin to feel their usual level of energy and regain their ability to get through the day without the need for rest and sleep, even if the procedure was minor. The tips that follow are intended to prevent pain, provide more time for rest, prevent injury and provide some entertainment while. The foot is compromised of 26 bones. The talus bone, the second largest bone in the foot is shaped like the hump of a turtle. The navicular bone is a smaller rectangular shaped bone located immediately in front of the talus. The talus bone is critical as it absorbs the forces of walking, standing and running and transfers them to the other bones in the foot (1).Running after talonavicular.

Postoperative Rehabilitation Protocols OrthoN

A treatment: When surgery is indicatd to treat a scoliosis it will involve a spinal fusion. A fusion is a surgery allowing for bones to be joined together and usually there is a correction of the scoliosis with the surgery with use of spine implants or instrumentation which enhances the healing rate of the fusion while maintaining the scoliosis. Therapy protocols recommended by Orthopedics & Sports Medicine BayCare Clinic specialists for shoulder, knee, hip, leg, foot, ankle, elbow or hand surgery

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Kidner Procedure Post-op issues - HealthBoard

The surgery consisted of debridement of a marginal flap-like tear. This was a split tear that had progressed to the margin of the tendon at one end. The flap constituted approximately 10% of the width of the tendon and was approximately 4 cm in length. The procedure consisted of removal of diseased tissue only Your family will return to the surgery waiting area. Once in the operating room, you will receive anesthesia and your procedure will be preformed. After Surgery. Following surgery, you will be taken to the post-anesthesia care unit where an RN will monitor and care for you while you recover until you are ready for discharge Kidner Procedure Post-Op Issues. I had the Kidner procedure two years ago due to a painful accessory navicular on my left foot. Now I have what appears to be a bone spur on top of that same foot (metatarsal?), and a cracking sensation when I move my big toe up and down. Additionally, I have daily pain, tightness, and a general feeling of.

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Kidner Procedure Lewiston Orthopedics, Lewiston, I

Surgery. Well hello viewers/soon to be surgery goers. My name is Kristy and I'm going to be having Foot surgery for the Second time. The first time I had surgery was June 8th 2011 and I got three surgeries done on my RIGHT foot. .Bunionectomy. .Calceanal Osteotomy. . Kidner Procedure Orthopedic Resident - USA, 2013. Increase your OITE scores by having access to both Academy SAE questions and Orthobullets Virtual Curriculum questions. Identify your areas of strength and weakness with our monthly diagnostic Milestone exams. Enjoy unlimited access to our study plans, including OITE and CORE Curriculum Perfect. I will go with the graft part and dismiss all the other stuff that 27658 states. The coding company said As per report, it was done at ankle near malleolus and considered as secondary as conservative measures already attempted - 27659 I had already asked the coder to explain her decision so I didn't want to question her anymore but don't understand her answer as secondary

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Kidner Foot - Columbus Podiatry & Surger

Figure 1. Week 1 Post Kidner Procedure in Patient #1 Figure 3. Week 12 Post Kidner Procedure in Patient #1 Wound covered with the silver hydrogel dressing. Utilization of Silver Hydrogel Sheet Dressing on Post-Surgical Incisions: A Pilot Study in Foot and Ankle Surgery G.M. Wobst1*, M. Galli1, N. Protzman2, S. Brigido Post-op Protocols John G. Kennedy, MD, FRCS, Lower Limb, Foot and Ankle, Cartilage Restoration, Orthopedic Surgeon, New York, NY / Foot & Ankle / Patient Surgery Binder / Post-op Protocols All American Procedure Part of the practical, highly illustrated Operative Techniques series, this fully revised title by Drs. Glenn B. Pfeffer, Mark Easley, Beat Hintermann, Andrew Sands, and Alastair Younger brings you up to speed with must-know surgical techniques in today's foot and ankle surgery.Step-by-step, evidence-based guidance, including numerous videos online, walks you through new procedures and.

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Hallux valgus deformity if symptomatic despite conservative efforts can be reconstructed with a variety of surgical procedures with different post-operative protocols. We would give you a detailed explanation of the entire procedure and options, why that specific procedure should be done, post-operative protocol and what to expect post-operatively KIDNER PROCEDURE. It is a TAL Rerouting tibialis ant thru a keyhole made in the navicular without detaching it from its insertion (base of first met and medial cuneiform) If other procedure also the post-op is dictated by other procedure. NPO TIMES for new born up to 6 months Surgery often involves a calcaneal osteotomy, which cuts and shifts the heel bone in order to transfer another tendon to be used in place of the torn tibial tendon. This procedure is consider the most common treatment for this condition and offers highly effective results with a low risk of recurrence MedStar Union Memorial Hospital Fellowship, Foot and Ankle Orthopedics, 2013 - 2014. Thomas Jefferson University Residency, Orthopedic Surgery, 2008 - 2013. Northwestern University Feinberg School of Medicine Class of 2008. University of Illinois at Urbana-Champaign B.S., General Engineering & Biological Engineering, 1999 - 2003