Hello all,
In my opinion, the biggest issue and obstacle faced in limb lengthening is the damage and poor adaptation of soft tissue to the newly formed bone. While the procedure, lengthening, pain etc. can be difficult and lengthy, once it is complete, the bone is functionally no different than that found in the rest of your leg and should, in theory pose no more problems. The same cannot be said for the soft tissue, ligaments, blood vessels, muscle etc. which appear to be stretched and adapt poorly causing numerous issues ranging from loss of athletic ability, fatigue to more serious and dangerous issues such as permanent damage through plastic deformation if lengthening goes beyond the upper limit of what the soft tissue is capable of.
I recently put the following 2 questions to Dr Birkholtz in his respective thread and I am awaiting his reply, until then I shall post them here in an attempt to create some discussion.
1) Soft tissue is one of the largest issues in regards to limb lengthening. Is there a medical consensus on why soft tissue doesn't adapt the same way it does during natural bone growth? We are all aware that after growth plates fuse no more growth can occur even under the same hormonal conditions but why does the same issue of growth of soft tissue occur where they technically have no 'end point' similar to plate fusion? Could one not accurately reproduce the hormonal conditions in soft tissue growth to mimic that found in natural growth? I believe I have read some studies that refer to issues with cell reproduction of soft tissue in regards to this.
2) A second question regarding soft tissue, after leg lengthening, does the body ever truly recover to the stretching even several years after combined with consistent physical therapy (if lengthened to reasonable standards rather than over lengthening leading to plastic deformation which I assume is permanent), creating new tissue as found in someone with legs of that natural length or does the body just adapt and become more flexible rather than truly recovering, with the soft tissue always being stretched to accommodate the new bone?
It raises other questions that just cannot be answered currently. Stem cell treatment sounds promising to address such issues but is currently in its infancy unfortunately, I hope that research in this field is furthered and can be applied to limb lengthening patients to ensure soft tissue adaptation and athletic ability isn't diminished.
Thoughts?
Soft tissue adaptation is the biggest obstacle found in limb lengthening.
You make some very valid points. The issue with speed is that no matter how slow we lengthen, it must be at a rate at which consolidation won't occur which will always be at a faster rate than ever found naturally. I wonder if theoretically, we could lengthen over a much longer amount of time would the effects not be such an issue, obviously, having a broken bone such a time span without consolidation practically would be impossible.
It makes me wonder if in an ideal world where finances, time, pain and complications weren't an issue (Oh how one can dream), would doing 2 or even 3 small surgeries in total with adequate consolidation and recovery between be a much more optimal process than simply one surgery and one phase of distraction.
I hadn't considered the effect of pelvic growth, thank you for bringing it to my attention.
You are of course correct in regards to the role hormones play in relation to growth and that human growth hormone is but one of many hormones which all play a part in growth. I think there is massive potential in hormone and stem cell therapy in the future to address many of the issues found.
Iwannabetaller - Great minds think alike, I said a very similar thing in the post above yours including the theory of slow lengthening, the issue with unwanted consolidation and the theoretical re-breaking and lengthening and whether that would allow the soft tissue to adapt more efficiently compared to traditional lengthening.
The question about Tony Robbins raises a very interesting point, he grew an astronomical amount in a very short time period yet suffered no physical ailment (apart from the complications related to acromegaly/excessive growth hormone) that I know of. As I mentioned in my original post, if we were able to fully mimic hormonal levels during natural growth would the soft tissue react accordingly or is there another unknown issue/upper limit in which soft tissue reaches its own equivalent of epiphyseal plate closing after a certain amount of time that will no longer adapt to additional growth?
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