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[Javier3]

Hello, my name is Javier and I have been reading posts in this forum from 3 years ago.

I think we are on the way to make a new big jump when it comes to Limb Lengthening techniques (after the jump from externals to internals). Israel filled a bone gap of a person after a bycicle accident successfully and now is now starting Clinical Trials.

I am a very skeptical person, who doesn't believe in miraculous stem cell injections that could make you somehow taller, and I am aware of limb lengthening limitations, risks, etc.

Today, there are 3 main reasons why Limb Lengthening is something extremely tough:
- It is very expensive (if done with well reputated doctors), especially for the devices and the skills needed to perform the surgery.
- The down time is too long (taking up to 2 years if not more) because of the slow healing process of our bodies.
- As the process is too complex, you have to gain a lot from it (who would legthen only 3 cm for that price and risk?)

Here I leave some articles, but there are more, you can google for further research, and the company gathered few millions of dollars in investments, as it is selling stocks in the stock market:

http://thenationonlineng.net/doctors-implant-lab-grown/

https://www.calcalistech.com/ctech/articles/0,7340,L-3733853,00.html

http://www.globes.co.il/en/article-successful-bone-implant-boosts-bonus-biogroup-1001216426


One article says:

"Meretzki said surgeons wrapped muscle fibres around the new bone tissue segment to help stabilise it.

He said within two months it had developed into normal bone and bonded to the surrounding shin bone."

"Bonus BioGroup CEO and President Shai Meretzki said this week’s experimental procedure “sets a new standard of hope for rapid healing in a wide variety of cases.”

Looks like a future is possible where you can have osteotomy done (which is itself a relatively simple procedure, not like inserting a rod, stretching 1mm a day to 6 or more cm because otherwise the process won't be worth, leaving it for so long, depending on natural bone healing process, etc.), stretch a very few cm (2-2,5cm) and letting it heal like any other fracture. I think what you would have in the end is very similar to a simple fracture, wich requires a plaster and absolute repose. Then it will be time to return to normal life, make your soft tissues get used to the new length, and then MAYBE consider another surgery to add more few cms. The point that makes it something worth to think about, is the fact that this technique would be much, much simpler than the current limb lengthening techniques.


Once bone fills are possible (there are many reasons to research further in bone fills, because bone grafts are performed daily using bone from another bone from the same person, and is a rapidly developing field in medicine which involves many procedures in orthopedics), we then will just wait for it being used to treat bone defects. EpiBone (for example) is working for the same, and their main goal is to treat bone defects (like leg length discrepancy). Nobody will research into bone grafts to make cosmetic limb lengthening, obviously, but once the technology is ready, Limb Lengthening Doctors will be able to use that technology (which is in fact simple theorically: if you can make a bone graft to fill a bone gap, then you have it, after that, you only need to wait it to fuse with the bone, as it happens with any fracture where the space between bones is less than 1mm because they are touching themselves).

This would be great to people who already did LL too!, as they will have a greater variety of techniques to allow them to add few cms more.


What do you guys think? I am talking about 5-10-15 years. Life is very long, and doing quick 2,5cm lengthenings will make it possible to avoid our body to not be able to cope with a lengthening more than 5 cms in the future, as we are doing now (I am considering doing Limb Lengthening too, I am not against it). You may not be very aware (Height neurosis sucks, I know, I have Major Depression because of it, and you think that or you have 10+cm or it won't be worth), but 2,5cms will significantly increase the number of events where you see somebody a bit shorter than you or about your height and gain that small injection of happiness, and if you repeated after 1-2 years when your body addapted, you already gained 2 inches. 

I honestly don't see it strange to think that bone fills for bone defects are an interesting field for the orthopedics community.

I sincerely thank you for your attention and I am very sorry to steal a part of your time. I tried to address with the most respect possible.

Sincerely,
Javier.

[myloginacct]

Hey, Javier. Thanks for taking the time for making the thread and writing down your thoughts.

I think we actually discussed it a little bit back when it just happened.

[Android]

Nice links, much better.

This would be a nice touch up years down the line after CLL, to correct proportions and whatnot (e.g. arms, lengthening discrepancies).

[extremis]

@Javier

As myloginacct mentioned, we did in fact discuss this procedure a bit a few weeks ago.

It's nice to see a new procedure in the works, if only because the existence of competition will drive down the cost of traditional distraction osteogenesis.

However, to be frank, I honestly can't see very much difference between this and distraction osteogenesis. The only real differences I can think of is maybe the total time investment will be slightly reduced.

It really doesn't seem to do much to resolve the central issue with distraction osteogenesis, which is the distension of soft tissue which leads to permanent loss of physical ability. At the end of the day, from what I can see, this procedure is basically just a different way to do the same thing: pull apart the bone and wait for the space between the break to fill in with new bone. It doesn't address the soft tissue problem at all.

Soft tissue doesn't "adapt". It doesn't "grow" the way bones do. When stretched beyond its natural limits (as in distraction osteogenesis or this procedure), it distends, which decreases its maximal tensile strength and results in a loss of range of motion and ability to generate force (through contraction). It's like a rubber band that gets stretched out beyond its limits. It doesn't go back to how it was before and instead ends up much weaker as a result.

As far as your issues with stem cell procedures go:

I am a very skeptical person, who doesn't believe in miraculous stem cell injections that could make you somehow taller, and I am aware of limb lengthening limitations, risks, etc.

https://www.kp.ru/daily/26526.3/3544077/

http://www.naturalheightgrowth.com/2016/04/30/big-updates-stem-cell-height-increase-research-done-russia-alexander-teplyashin-plastic-surgery-clinic/

Another doctor who's developed a similar method but has yet to test it due to being U.S. based (and thus restricted by the FDA):

http://www.naturalheightgrowth.com/2015/09/10/eben-alsbergs-research-is-on-growth-plate-generation-re-implantation-and-even-transdifferentiation-game-changing-breakthrough/

http://engineering.case.edu/ebme/alsberg/publications

It's not really a matter of "believing" in them or not. They exist. At this point it's just a matter of drawing attention to them so researchers like this get the funding they need to do more research, organize clinical trials, etc.

[myloginacc]

By the way, I'd like to point out that the Wagner method of limb lengthening was abandoned due to a ridiculously high ratio of complications. From my understanding, they did the osteotomy and simply filled the gap with bone graft instead of slowly allowing the body to bridge the gap naturally (through osteogenesis), like it is common procedure for LL now.

We have to see the follow-up of the patients treated with this approach.

[myloginacc]

A tidbit from the news back then that I missed:

Two weeks ago, Bonus announced the successful injection of its bone graft in the jawbones of 11 people, in a separate clinical trial that started September 2016. Over several months, the graft created new bone growth in all eleven participants.

https://www.calcalistech.com/ctech/articles/0,7340,L-3727870,00.html

[wannagrowtaller]

I just hope this is not Teplyashin 2.0.

[wannagrowtaller]

2,5cms in one day is extremely stressful to your soft tissue (muscles and tendoms) and may not work well.

If this kind of treatment give us any help it is with faster consolidation and treating non union.

For the rest, this surgery will stay the same for next decades because you can't stretch much more than 1mm per day without problems.

People always think about the bone in this surgery and forget soft tissue are at least of the same importance.

[myloginacc]

This is from back then, and I had also missed it:

"For the first time ever, arm and leg were healed using a bone graft grown outside patient’s body, in an orthopedic clinical trial for filling extensive critical bone void in limbs"

http://www.bonusbiogroup.com/index.php/news-media/press-releases/item/29-for-the-first-time-ever-arm-and-leg-were-healed-using-a-bone-graft-grown-outside-patient-s-body-in-an-orthopedic-clinical-trial-for-filling-extensive-critical-bone-void-in-limbs

Excerpts of note:

"[...]  is pleased to announce that interim results for the first two months out of the twelve-month medical observation period for each patient participating in the clinical trial for filling extensive critical bone void in limbs – arm or leg, demonstrate that for the first time ever two patients have experienced forearm healing and another patient experienced thigh healing, within two months of implanting an injectable live bone graft manufactured by the Company."

"At Bonus BioGroup's manufacturing laboratory, fat tissue is separated into comprising cells that are divided into different types. While no use is made of fat cells, cells necessary for creating natural human bone are collected, from which the Company manufactures, within two weeks of sampling the patient's fat tissue, an injectable bone graft made of tiny bone grains, ready to be implanted in the patient's body."

Depending on what they meant by healing, this could mean:

Two weeks for manufacturing the graft, and two months for the healing of a gap, without the chance of rejection.

This would obviously make CLL faster.

2,5cms in one day is extremely stressful to your soft tissue (muscles and tendoms) and may not work well.

If this kind of treatment give us any help it is with faster consolidation and treating non union.

For the rest, this surgery will stay the same for next decades because you can't stretch much more than 1mm per day without problems.

People always think about the bone in this surgery and forget soft tissue are at least of the same importance.

This is not the only technology arising out of the tissue engineering field that could be of interest to CLL.

http://www.limblengtheningforum.com/index.php?topic=9352.0

[wannagrowtaller]

I'm skeptic.

[milesdavis]

Hello, is there any news on this interesting topic?