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Will Being Taller Cost You Your Knees? The Truth About Limb Lengthening and Arthritis
When you get started into the world of orthopedic surgery, you soon hit the scary forums. You see people talking about infections, nerve hurt, and what is the biggest pain ever ridden of all people: arthritis.
It is a valid fear. You are taking a functioning leg, cutting the bone and forcing it to change shape. This is all fine to be worried that you're going to trade a few inches of height for a lifetime of crippling joints tomorrow.
Does limb lengthening surgery cause arthritis?
The answer is not a simple yes or no. It is all about geometry.
The Tire Alignment Analogy
To understand your knees, you have to think about your car tires.
If your car wheels are perfectly aligned, the tires wear down evenly. They last for years. But if your alignment is off by just a tiny bit, the tires wear out on one edge very quickly.
Your knees are the tires. The cartilage inside them is the rubber.
If a surgeon lengthens your legs and keeps your alignment perfect, your "tires" will continue to roll smoothly. This pressure is evenly distributed across the joint surface. In this way the risk of developing arthritis is very low.
However, if the bone heals at a weird angle, or if the surgeon does not pay attention to the mechanical axis of your leg, you end up with "malalignment." This puts massive pressure on just one side of the knee. That is when the cartilage gets ground down, leading to osteoarthritis.
Distinguishing the Types of Arthritis
It is really important to use the right words here because people often get confused.
By way of association, osteoarthritis is almost always referred to in the context of joint damage caused by surgery. This is the "wear and tear" type caused by friction and mechanics.
We are generally not talking about rheumatoid arthritis.
The term rheumatoid arthritis is completely different. It is an autoimmune disease that your body’s immune system attacks the skin of your joints. It is usually genetic or triggered by environmental factors, not by broken bones. Limb lengthening surgery does not give you rheumatoid arthritis. You cannot "catch" an autoimmune disease from a surgical saw.
But it is more risky if you have already contracted rheumatoid arthritis. Your joints are already vulnerable, and adding tension to the lengthening can also trigger a flare-up or damage much faster than it does in healthy individuals. Most surgeons will be very hesitant to operate on someone with active RA.
The Pressure Cooker Phase
There is one specific time during the process when your joints are at real risk. It is the distraction phase.
As the device pulls the bone apart, it pulls the muscles tight. These tight muscles squirm the knee and hip joints with immense force.
If you try to lengthen too much or too fast, that pressure can become dangerous. It can crush the cartilage. This is why experienced surgeons have strict limits. They know that if they push past a certain point, usually around 5 to 8 centimeters depending on the bone, the pressure on the cartilage becomes unsafe.
This is also why physical therapy is non-negotiable. When the muscles are loose, that heavy weight does not affect the joint and in fact, it protects your cartilage.
The Unexpected Bonus: Fixing the Joints
Here is the twist that surprises a lot of people. In many cases, limb lengthening surgery actually saves patients from arthritis.
A lot of people seeking this surgery have naturally bowed legs (varus) or knock knees (valgus). If you have bowed legs you are already on the road to arthritis because your weight is placed all your weight on your knees.
A skilled surgeon can kill two birds with one stone. They can lengthen the leg and straighten the bow at the same time. By fixing your mechanical axis, they are actually protecting your knees from future wear. You become taller but you also have better biomechanics than you were born with.
The Verdict
So, will you get osteoarthritis?
If you choose a bargain-bin surgeon who ignores alignment, the risk is high. If you push your body too far and ignore the safe limits, the risk is high.
But if you choose an expert who understands the geometry of the leg and abide by safety protocol, you can’t survive in the misery of joint pain. Only you are set to have a different view of the world.