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[maximize]

Here is an article which reviews the use of low intensity pulsed ultrasound (LIPUS) and pulsed electromagnetic fields (PEMF) for bone healing during leg lengthening:

https://bmcmusculoskeletdisord.biomedcentral.com/track/pdf/10.1186/s12891-016-1259-5.pdf

These therapies can significantly reduce healing times during distraction osteogenesis. To quote:

We found that the mean healing index was 11.7 days/cm faster when using bone stimulation that in the comparison cohorts (33.7 vs 45.4 days/cm).

This is a pretty massive difference. For a maximal 8 cm distraction this would mean non-stimulated healing might be 363 days (12 months), while stimulated healing would be 270 days (9 months). You would be shaving off 25% of your recovery time with these modalities.

The Exogen is the most popular LIPUS technology I'm familiar with. It costs I believe around $1600 which is not much compared to the cost of LL. I am not sure what the gold standard of PEMF is but I see one called the OssaTec which would fit nicely over femurs for example. It is probably cheaper if anything.

Why are most current surgeons not using LIPUS and PEMF as part of their routine protocols? It seems like they should be automatically incorporated from day 1 by everyone.

[tallmen]

You can buy them yourself and use them.

[HeightGain]

Research on them is not robust

[maximize]

Apparently the "Orthopulse" devices described in this article are made by OssaTec, so that probably is the main PEMF therapy option:

https://www.researchgate.net/publication/225146108_Pulsed_electromagnetic_fields_in_the_treatment_of_nonunion

It looks like you can't buy the Ossatec PEMF devices as a regular customer. Looks like you must be a doctor or specialist as it's a medical device.

I don't see any easy place to buy an Exogen either so if you wanted these I presume you'd have to ask your surgeon to order them for you and pay them back.

If anyone is undergoing LL now, could you show your doctor the article in the OP and ask them what they think? That is likely the best summary of all available evidence and it seems to be quite favorable.

From what I see, these devices don't have a major benefit for normal fractures but that is to be expected - normal fractures heal for everyone who is healthy in a few weeks. There is also high noncompliance because people don't worry about their broken wrist not healing.

But for distraction osteogenesis (limb lengthening) and nonunion where we are measuring progress in the scale of months and sometimes years, the evidence seems quite clear.

I think everyone should be using this (OssaTec + Exogen) or at least talking to their surgeon about it. For just a few thousand more you could cut your healing time by months and reduce your risk of nonunion considerably as well.

[maximize]

Just realized I screwed up the product links, so for reference:

Exogen:

https://www.exogen.com/us/

Ossatec:

https://www.ossatec.eu/en/index.html

The Ossatec unit must be ordered by a doctor here:

https://www.ossatec.eu/en/products/bone-growth-stimulator/apply-for-the-bone-growth-stimulator.html

Probably same for the Exogen since their "How to get Exogen" link just leads to a physician locator.