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Limb Lengthening by Precice 2.2
Precice 2 system (NuVasive Specialised Orthopaedics (NSO)) offers a less-invasive procedure in Limb Lengthening surgery. It has been used since 2011, and has been one of the most preffered method by most patients so far in terms of amenity and biological safety. Elongation is achieved using intramedullary techniques, with nails that are fully implantable in the patient. The two ends of the telescopic nais slowly pull apart creating a gap in the bone. In addition to this, there is no external metal device attached to the legs. These are the most notable advantages over traditional methods used external fixators which have been related to infuriating discomfort, prolonged treatment times, and the risk of pin-tract infections, which may lead to osteomyelitis.
PRECICE 2 nails are American-made intramedullary nails used for limb lengthening. An External Remote Controller (ERC) is utilized to lengthen the nail, which interacts with magnets within the nail.
You can read our Lon vs Precice 2 article.
5 Phases of Limb Lengthening Surgery with Precice 2 Method
We explained day by day guide for your surgery process.
1. Pre-Operative: 1-2 Day
Upon your arrival, you will be warmly welcomed by your caretaker at the airport and transferred to your hotel for rest. The next day, you will meet with your surgeon for a face-to-face consultation and undergo pre-operative medical tests, including an X-ray. A physical examination will be conducted to assess flexibility and determine the optimal nail size. To help you relax, you will enjoy a complimentary tour of Istanbul, allowing you to experience the city's rich culture.
2. Intra-Operative: 6 Days
Day 3: The much-anticipated day of your limb lengthening surgery arrives. The skilled surgical team will perform the procedure with utmost precision.
Day 4: Your surgeon will visit you for a follow-up and guide you through a short walk to assess your initial recovery.
Day 5: Dedicated to receiving targeted physical therapy to enhance your healing and mobility.
Day 6: Offers a chance to relax and recover in comfort.
Day 7: You will receive additional physical therapy along with a detailed demonstration of the lengthening process.
Day 8: You will be discharged and transported home in a private ambulance, ensuring a safe and smooth journey as you continue your recovery.
3. Post-Operative (Lengthening Phase): 2-3 Months
Day 9: The distraction phase begins, with 1 mm per day for LON and 0.99 mm for Precice 2.
Day 10-90: The lengthening phase duration varies based on the targeted height increase. During this time, the number of physiotherapy sessions will be tailored to your overall condition. This phase is crucial for regaining mobility and functionality. You'll be allowed to bear partial weight with a walker and use a wheelchair. Throughout the lengthening phase, necessary medical care and painkillers will be provided. Follow-up visits will be conducted at the facility, and regular X-rays will be taken to detect any early signs of complications, allowing for timely preventative measures.
4. Pre-Consolidaiton Phase: 20 Days
Day 90-110:Once sufficient bone consolidation is visible on the X-ray, patients will receive instructions on how long to use the walker and then transition to crutches. If there is a delay in bone consolidation, the duration of crutch use may be extended.
5. Recovery Phase (Bone-healing/Returning to Daily life): A Year
Day 110-475: Patients are required to send X-rays at regular intervals to allow remote evaluation of bone healing progress. After the lengthening phase is over, they are asked to use a walker & crutches for about two months, and then, walk unaided. Heavy physical exercise and sports are strictly prohibited until the surgeon provides approval. Apart from these restrictions, patients can freely return to their daily routines and work life.
*Please note that the information and the duration shared in the timeline are to give an overall insight regarding the limb lengthening process. The process can be completed early or later than it is anticipated depending on the circumstances and amount of elongation planned to be achieved!
Components of Precice 2
External Remote Controller (ERC);
External Remote Controller is a portable magnetic device that makes the elongation occur by pushing the button on it. Thus, controlled lengthening phase is provided thanks to it.
Intramedullary Nail;
Intramedullary nail, or rod is used as an internal fixation and is made of titanium alloy. The doctor decides the size of the nail by reviewing the X-ray images. (8,5 mm, 10,7 mm, 11,5 mm or 12,5 mm) During the operation, it is surgically embedded into the bone cavity. As the nail is biocompatible, it does not contain any elements that will cause harm to the body.
Important Information about the nail: Patients weighing up to 40-70 kg are permitted to walk with the support of a walker depending on the size of the nail and limb being treated. However, patients are allowed to walk in activities that do not put too much weight on the nail under the supervision of the doctor. For instance, going to toilet or walking exercises in physiotherapy sessions. Apart from this, a wheelchair must be used during the lengthening period owing to the weight-bearing capacity of the nails. Because, the mechanism may be damaged because of putting too much pressure on the legs.
Two Surgeries with Precice 2
If Precice 2 is chosen as a surgery method for limb lengthening, there are two operations that are performed;
- First Surgery; An intramedullary nail is inserted into the medullar cavity of the bone. Patients lengthen the bone gradually by 0,99 mm per day by pushing the button on ERC. (Lengthening is carried out three times a day / 0,33 mm x 3)
- Removal Surgery for Intramedullary Nails; Intramedullary nail can be removed upon patient’s request after the full bone consolidation is completed. It can take a year or one and half years to get rid of the nail with a short procedure.
Advantages and Disadvantages of Precice 2 Method
Advantages;
- It offers less invasive procedure, and less painful process compared to classical methods.
- It bears less risk of getting infection since there is no external devices attached to the legs. (e.g. LON)
Disadvantages;
- The surgery cost is pricy comparing to the other methods such as LON and Holyfix.
- As the weigh-bearing capacity of the nail is limited, patients must use a wheelchair during the lengthening phase. Therefore, some patietns consider choosing Stryde Method to avoid using a wheelchair.
The ‘Precice 2’ methodology is highly preferred by our patients for these simple reasons:
- Patients go through the lengthening process with minimal pain except for the first week.
- Less scar marks will appear on the legs beacuse of the minimal insicions and aesthetic stitches.
- Patients will have less complication, safe and more comfortable lengthening period in comparison to the other methods (e.g LON, Holyfix and Ilizarov)
As a few incisions are made for each leg compared to the classical methods, the scar marks will not be notable too much. The surgical wounds are stitched with dissolvable sutures and covered with waterproof dressings. Nevertheless, the scar marks will fade away as time passes by, and will not be eyeful. Especially, our surgeon ties off stitches aesthetically. If you think you may have sensitive skin against scar marks, you may find out some useful tips for the ways of minimizing the scar marks by watching the video below.
As any other surgery, there are always risks and complications that might occur. As long as the doctor applies the right technique, the hygienic environment is established at the hospital, and proper post-operative care is provided, the risks and the complications are preventable and treatable. As Wannabtaller Team, the first priority is always patients’ safety for us. Yet, every person has unique physiology and some unpredictable conditions might occur such as non bone union or slow bone union. You may visit our blog writing to find out more information related to this issue; "Limb lengthening Side effects, Complications and Risks"
- Assoc. Prof. Dr. Yunus Öç(Istanbul, TURKEY) – 22,850$ LON method, 48,500$ intramedullary nail (PRECICE 2.2), Precice Stryde, 22,850$ limb shortening surgery
- Dr. Paley (the USA) – Bilateral femur lengthening (up to 8 cm of height; cost $97,500 USD,PRECICE-Stryde) / Bilateral tibia lengthening (up to 5 cm of height; cost $109,000 USD, PRECICE-Stryde)
- Dr. Jacob Rozbruch (the USA) – $125,000 (Femur or Tibia) / Nail Removal Fee: $20,000 (Femur or Tibia)
- Dr. Shahab Mahboubian (Hollywood CA, the USA) – Bilateral femur lengthening (Precise nail) – $75,000, Bilateral tibia lengthening (Precise nail) – $85,000 & Combined tibia and femur lengthening 3-4 weeks apart – $155,000
How many months should I stay for this procedure?
Limb lengthening is not a simple procedure to go through. Considering broken bones and the recovery process, patients should spare a considerable amount of time for it. Notably, the first 3 months are a crucial period for patients in order to get through the process healthily as much as possible. The lengthening period needs to be observed closely by the doctor apart from the recovery, the functionality, and the health condition of the patient. Besides all these, patients must take a proper physiotherapy session from a physiotherapist who is well familiar with the post-operative process of limb lengthening. Patients desiring to have limb lengthening surgery need to stay here for at least 3/4 months by taking into account all these factors.
We provide patient accommodation, post-operative care, and physiotherapy services at Kumburgaz Marin Princess Hotel. For other accommodation facilities and prices, please visit Accommodation services page.
- Accommodation + 3 meals/day
- Personalized Physical Therapy
- X-rays, tests & examinations
- Medications
- Psychologic Counselling Service (Twice a month)
- Dietitian Services (Twice a month)
- Fitness, Free WI-FI internet, daily room cleaning, clean towels, and linen changes
- 24/7 business center use for those who continue their work remotely
- Activities outside the hotel and special tours for the patients to relax, breathe, and increase their motivation once a month
All inclusive: 4,550$ 3,580$/ per month
(3 month-package: 10,540$)
Sonny 2024-08-09 05:55:02
I really want to do leg lengthening, but I'm confused about the residence permit. What residence permit do your patients usually use? ikamet? or visa? If visa, what visa? because I want a recovery process and regular control near the hospital, this requires a residence permit of maybe 1 year, I'm confused if I use a visa it can only be 3 months.
ReplySonny 2024-08-06 12:15:47
Hello doctor, I have a question 1. What visa do I apply if I stay in Turkey 2. After the elongation is complete, how long can it take to walk normally 3. After full recovery can I play football, jump, etc. 4. What is the same quality as the original bone and natural bones Is it strong not easy to break 5. Explain whether you use the Precice 2.2 method, what is the pain for the pain lower than Lon 6. What if the bones have hardened and are strong, then after a few years of fracture, what about it? 7. If I stay in Turkey, the hospital provides apartment facilities What facilities do I get? Can I request a personal assistant? 8. What is the total cost of Precice 2.2 along with its accommodation, residence, medicine, etc
ReplyWanna Be Taller - Makbule2024-08-07 11:24
Hello, thank you for your comment. 1. You can visit the government's official website to see the visa application inquiries for your country. Generally speaking, patients are exempt from visa applications and receive 90-day visas. (https://www.evisa.gov.tr/en/) 2. Regardless of the surgery method, 2-3 months take for the distraction phase depending on how much length you want to achieve. Usually, patients use a walker and a wheelchair to get assistance for walking for the first 4 months. When they enter the fifth month, they move on using the crutches depending on the bone healing speed and range of motion(follow-up X-rays and videos that show the patient’s gait are sent) In the 6th month, they either move on to using both crutches or a single crutch again based on the evaluation done by the specialists. In the 7th month, they mainly walk unaided. Therefore, walking without any assistance might take 6-7 months after the main surgery. Also, regaining full gait might take 8-10 months after the surgery. --- This period is accepted after having one LL surgery. 3. After the bone fully solidifies and heals, the new bone becomes as strong as any other bone in the body. It doesn't get weaker or worse with time. Patients can freely return to engaging with the physical activities they enjoyed before the surgery. You will thus be able to engage in all the physical activities you enjoyed before the operation. It takes roughly 1-1,5 years to run and do other heavy activities. 4. Limb lengthening surgery stimulates new bone growth by gradually separating bone segments with an external or internal device. This creates a gap filled with new bone tissue called "callus", which solidifies over time. Factors like age, surgery location, and technique affect the shape of the new bone, which likely won't match the original bone exactly. The goal is a functional and aesthetically acceptable result. The fused bone becomes exactly similar to the original bone at the end of the 7-year bone remodeling process. It will be as strong as it used to be. 5. Considering pain management, the Precice is slightly more advantageous than the LON method. 6. It will not be simple to fracture the healthy and consolidated bone 1,5 - 2 years after the limb lengthening surgery. Yet, if it occurs because of a car accident or falling, recommended treatments by the doctor are applied. 7. The team already provided 6 days of caretaking service. 5 days at the hospital and 1 night at the hotel, however, if patients would like to extend it, it will be subject to an additional cost. 8. Based on the current prices, bilateral Precice 2 and a 3-month package at the hotel cost around 59 Thousand USD. Kindly get in touch with our patient consultation expert for more information through email (support@wannabetaller.com) or phone (+90 531 988 30 90) Regards, WBT - Medzonia
Saad ehsan 2024-04-09 20:22:33
Hello, I have some questions regarding the limb lengthening surgery. 1. What is the price for 15cm height increase, including accommodations, foods and physical therapy ? 2. if 15cm require two surgery, can I do both surgery at the same time? 3. what is the duration of stay in Turkey? 4. which method is safer and produce minimum scars? 5. when I can drive my car? 6. when can I go back wo work (Most of the time I seat behind my desk)? 7. when can I walk normally, and when can I do sports like football? Thank you.
ReplyWanna Be Taller - Makbule2024-04-15 14:00
Hello, detailed information will be sent through email address. Regards, WBT - Medzonia.
Jacob 2024-03-22 04:51:57
Hello, my height is 165 cm and i weight 68kg. Can i have a 10cm increase on one surgery or only 8.8cm?
ReplyWanna Be Taller - Makbule2024-03-22 10:40
Hello, the amount of lengthening that can be safely achieved in a single surgery depends on various factors, such as the age and overall health of the patient, the location of the bone that needs to be lengthened, muscle flexibility, nerve durability and the surgical technique used. It's important to note that pushing the limits of safe lengthening can increase the risk of complications, such as nerve damage, joint stiffness, infection, muscle contracture, and bone healing problems. It's essential to consult with a qualified and experienced orthopedic surgeon who can assess your individual case and provide guidance on the safe and realistic limits of lengthening for you. Overall, while it may be possible to achieve up to 9-10 cm of lengthening in a single surgery, the safety and feasibility of this approach depend on several factors and should be carefully evaluated by a qualified orthopedic surgeon. Maximum pushed limit with LON that the doctor can allow if everything is on track; Femurs: 9 – 9,5 cm Tibia: 7,5 cm Maximum pushed limit with Precice 2 that the doctor can allow if everything is on track; Femurs: 8 - 8,3 cm Tibia: 7 cm Regards, WBT - Medzonia.
Sara alsaleemi 2024-02-21 21:27:23
Hi team Need to know the total amount to pay for the surgery and the accommodation Thank you so much
ReplyWanna Be Taller - Makbule2024-02-27 13:00
Hello, detailed info will be sent to your email address. Regards, WBT - Medzonia.
Deep 2024-01-23 11:32:41
Hi there, What are the wait times for booking a surgery? I am also on testosterone replacement therapy and i am wondering if that affects the bone growth or would create any issues. I am also 42 years old, does my age factor matter?
ReplyWanna Be Taller - Makbule2024-01-24 13:09
Hello, thank you for the provided information. For bookşng a surgery date, patients are required to give us notice at least 1-1,5 months in advance. As to taking testosterone treatment, the brand and the dosage must be relayed to the doctor for his evaluation. In the meantime, for patients who are over 40 years old, the doctor wants to see bone densşty results and X-rays in advance. For further information, you can contact our patient consultation expert. Regards, WBT - Medzonia.
Dhruv 2023-11-25 06:15:20
I have a couple of questions: 1. What would be the total cost including all unexpected expenses, like snacks, extra food food, etc. for both of the methods in Canadian dollars? 2. In case of a serious injury what is the procedure? Should I save up extra money incase, to pay for any follow up health concerns or is that unnecessary? Also, do you know if any serious injury would be covered by the Canadian health care system or would I have to pay for it? 3. Is there any issue, if the person has high prolactin? 4. Is there any issue, if the person is doing testosterone replacement therapy? 5. In the 4 months that I am there, will I be in a state where I can work remotely? Like an work from home IT job? Or do you think that is not possible? 6. Would it be possible to do other types of surgery when I come to turkey, from a different place, like a rhinoplasty?
ReplyWanna Be Taller - Makbule2023-11-27 15:45
Hello, detailed info has been sent to your email address. Best regards, WBT.
Wanna Be Taller - Makbule2024-08-09 10:26
Hello, our team will send detailed info to your email address. As to visas, all foreign patients receive a 90-day visa as a tourist. If you aim to stay here for 1 year, you must have an excuse to stay here for that period such as studying at university, working in an international company, or proving that you must have an orthopedic surgery in Turkey. To require more information, patients must contact the Turkish embassies in their own countries. Regards,WBT - Medzonia.