I want to talk about some of the alternatives to limb lengthening surgery and then I’m going to speculate about some future possibilities.
So, currently, the only alternatives to limb lengthening surgery are for younger individuals whose epiphyseal plates haven’t fused after puberty. Because if your growth plates do close up shop...well then you’re done growing...for life. Typically this’ll happen sometime after age 17 for guys and age 15 for girls but can vary from person to person.
Now, let’s say that a growing boy whose growth plates haven’t fused yet and their family doctor notices they have a growth hormone deficiency and that they may not grow to be normal size or near their predicted max, then they can refer them to an endocrinologist to administer growth hormone therapy to assist in bolstering a stronger growth response.
GH therapy is often prescribed for teens with growth hormone deficiency, idiopathic short stature, dwarfism, Russell Silver, Turner, or Prader-Willi-syndromes.
Now if you’ve already ruled out poor nutrition and underactive thyroid for kids who have normal GH levels or who don’t respond to the GH therapy that isn't growing taller, it may actually be due to an IGF-1 (insulin-like-growth-factor-1) deficiency. Then something like Increlex can be used to help.
And then you have Vosoritide from the company Biomarin, which is an innovative biomedical drug that helps those with achondroplasia achieve better growth. Basically it binds to a receptor that essentially inhibits the FGFR3 pathway, which, if left alone to cause havoc, can affect how the chondrocytes convert to new bone.
This is similar to what CK Biotech is doing by making drugs that interfere with CXXC5, a negative feedback regulator of the Wnt/Beta-Catenin signaling pathway which can allow for normal bone growth in kids who still are growing.
So as you can see, when it comes to those who are still growing, there are quite a few options to assist with maximizing height. However, what about adults or those who’re at growth plate senescence? What options do they have other than the current limb lengthening surgery…
Well, unfortunately...none...as of yet. But I wanted to speculate on what could be in the future.
So the current limb lengthening technology involves breaking the legs, implanting some sort of lengthening device, lengthening the bones, and having to get a device removal all while mitigating pain through consistent rehab.
If there could be an alternative to any one of these steps, that would be progress. For example, there has been research started to try to induce stem cells to have bone cells transdifferentiate back into chondrocytes. If this works, it basically means you could “reactivate your growth plates”.
Also, the focus on LIPUS technology (which is low-intensity pulsed ultrasound) and how it could stimulate bone growth as some studies have been noted in jaw bones of rats but hey.
Finally, what about expediting the healing process with stem cells to help bone healing. Well this actually has been occurring for example I know some LL surgeons use BMAC injections to help patients with healing bones especially the tibia since it heals slower than the femur.
Well, perhaps we’re just daydreaming and hoping for the day where we could take a pill that will magically lengthen our bones at a slow enough rate we can control on our smartphones that won’t cause soft tissue problems and would be more affordable than typical limb lengthening…
BUT, unfortunately we’re not there yet so we’ll have to do our best with the current technology which is still amazing considering where it was just a decade ago.