The TALLER Limb Lengthening Procedure

Limb lengthening is a surgical treatment that corrects height proportion, balances the patient’s gait, and addresses aesthetic concerns. The process of limb lengthening requires time, patience, and precision. The reconstructive surgeon performs a surgical osteomy (breaks) on the femur and/or tibia through small incisions in the affected leg. 

A magnetic lengthening rod and pins are inserted into the bone which allows the leg to have controlled lengthening over a period of time. There is an external magnet that that is applied over the lengthening device which mechanizes a gear in the device and moves the telescoping rod. The magnet rotates the gears in the rod to increase the length of the limb. By utilizing this advanced technology, Penn surgeons can limit and /or eliminate the use of external fixation, which historically had been the device used.

What to Expect 

Our office is located at Penn Musculoskeletal Center – University City on the 7th floor within our Orthopaedics department.

We would schedule your initial consultation at this location with Dr. Mehta. He sees patients on Tuesdays. We would not schedule your surgery prior to your consultation, so if you are traveling from outside of the Philadelphia region, please plan on a second trip back for the surgery at a later date. We have listed below several hotels that are in close proximity to our office if you need to plan for overnight accommodations. 

At your initial visit, we will obtain plain X-rays of both of your legs, as well as a standing scanogram which is an X-ray that takes a picture from your hip bones down to your feet. At this visit Dr. Mehta will discuss the surgical plan, the desired height, and what to expect. We discuss a surgical date during this visit.   

Preparing for Surgery

We recommend that you maintain a healthy diet and healthy weight (BMI less than 30). There are no specific leg strengthening exercises that you need to do with physical therapy prior to the surgery. We will not perform the surgery on anyone who is actively smoking or using nicotine products due to nicotine severely impacting wound and bone healing. If you use nicotine products during your limb lengthening process, it can delay healing and lead to adverse outcomes. Dr. Mehta will take a full history during your consultation to rule out any comorbidities that may exclude you from surgery including osteoarthritis, osteoporosis, diabetes, obesity, or any metabolic bone disease. Based on your past medical history, we may recommend that you have blood work and an electrocardiogram preoperatively. If needed, those could be performed that same day at our clinic. 

Surgery would be performed at Penn Presbyterian Medical Center (located across the street from our clinic) at 51 N. 39th Street Philadelphia, PA 19104. The actual procedure takes approximately 5 hours, which includes getting prepared for surgery by anesthesia through the recovery period in the Post-Anesthesia Care Unit. You can expect to stay in the hospital for 2 nights after the procedure. During this stay, we will make sure your pain is controlled and that you are able to ambulate safely. 

You will be able to bear weight on both of your legs immediately after surgery, but you may require the use of crutches or a walker for stability. The lengthening device that will be used can withstand 250lbs immediately after surgery, allowing you to bear weight right away. A physical therapist will work with you while you are in the hospital to help you walk with these devises. 

Post Surgery

Once you are discharged from the hospital, you will work with physical therapy each day to work on leg strengthening exercises. If you are from out of town, we ask that you stay locally within the Philadelphia region for the first two weeks post operatively to work with physical therapy and come for your first post-operative appointment. Two weeks after your surgery, we will see you back in clinic with Dr. Mehta where we will take new X-rays to ensure everything is healing well, we will remove your staples, and we will have you begin using the external hand-held magnetic device to begin the lengthening process.

During the lengthening process, you will use your hand-held magnetic device two times a day. This will turn your internal rod 0.25mm each time for a total of 0.5mm a day. The duration of your lengthening process will depend on the desired height. Once you have reached your desired height, the lengthening device does not ever need to be removed unless it becomes bothersome. 

You will be placed on a medication called Lovenox for two weeks after surgery. This is a small injection you will be trained to administer in the stomach every day. After two weeks, you will stop taking this medication and take aspirin orally every day for blood clot prophylaxis.

We will perform X-rays and have you follow-up in clinic every two weeks for the first six weeks, then again at three months and six months. If you are not located in the Philadelphia area, it may be possible to setup a telemedicine appointment to follow-up if this is more convenient. We would ask that you obtain X-rays at an outside location and have the images and reports sent to our office.

You will continue to work with Physical Therapy on gait training and leg strengthening throughout the lengthening process. We do not recommend running or high-impact activities during the lengthening period, however we do encourage you to engage in low impact activities such as a stationary bike and walking.