So this is my first attempt at developing a real surgical strategy and process to use all of the knowledge i have learned up to this point to increase height.
Some things to note:
It turns out from rabbit studies that removal of the proliferative and hypertrophic layer in a growth plate but leaving the rest zone still there causes the proliferative and hypertrophic layer to regrow back. If you remove the rest zone layer however, you can’t regrow that back. This suggests that as long as you can create a rest zone type of chondrogenic structure, you can essentially regrow a growth plate over again.
It seems that the original growth plates were formed from the collapse and pressing together of the primary ossification center of the diaphysis and the secondary ossification center of the epiphysis. This give me (and maybe others ) the idea that to recreate a real growth plate over, you need to have two sets of growth occurring at the some time, close enough to press the two perichondrium layers (of the two growing ossification centers) together. It could be that the key to creating synthetic growth plate formation as close to the original thing is to
From Wikipedia on the perichondrium…
The perichondrium is a layer of dense irregular connective tissue which surrounds the cartilage of developing bone. It consists of two separate layers: an outer fibrous layer and inner chondrogenic layer. The fibrous layer contains fibroblasts, which produce collagenous fibers. The chondrogenic layer remains undifferentiated and can form chondroblasts or chondrocytes. Perichondrium can be found around the perimeter of elastic cartilage and hyaline cartilage. Fibrocartilage and articular cartilage both lack perichondrium. Perichondrium is a type of Irregular Collagenous Ordinary Connective Tissue, and also functions in the growth and repair of cartilage. Once vascularized, the perichondrium becomes the periosteum.
The key maybe is to press two layers of perichondrium together while still keeping the amount of pressure needed to be exerted by the sub-perichondrium bone growth in the radial direction boy the osteoblast’s activity.
Note: I am extremely unsure at this point about the difference between Type I collagen and Type II collagen and which goes where in the life cycle of the chondrocyte and the hyaline cartilage because I seem to be getting contradictory information from different sources.
So the real strategy.
This is derived from studying the procedure of how the surgical process of Autologous Chondrocyte Implantation and Autologous Matrix-Induced Chondrogenesis
1. You first collect cartilage samples from an area of the body that has hyaline cartilage, but of the same type as the articular cartilage at the end of long bones The best places I can think of is the nose, ears, other areas like the intercondylar notch or the superior ridge of the medial or lateral femoral condyle of the patient.
2. You remove the matrix of the cartilage using enzymes and then isolate the chondrocytes.
3. Grow the chondrocytes in vitro in a specialized lab. This will take 4-6 weeks. Create enough chondrocytes to do a re-implant.
4. Create an initial distraction in the bone. This will be similar to the hammer and chisel tool and application used on the ilizarov method. Only the cortical layer is fractured, by about 1-2 millimeters in thickness.
4.5 Drill holes into the cortical bone so that the mesenchymal and progenitor cells can reach the chondrocyte implant.
These 4 elements are needed to create cartilage (from my studies).
- progenitor cells
- mesenchymal stem cells
- growth factors
Let’s assume that the top 5 growth factors we need at BMP2, BMP7, some FGF (not sure which type), IHH, and IGF-1. Can we make a mixture or stable compound well enough to inject into the implant later?
The waste or excretion of chondrocytes are two compounds, type II collagen and proteoglycan. Hyaline cartilage matrix is mostly made up of type II collagen and Chondroitin sulfate, both of which are also found in elastic cartilage.
5. You also add a bilayer collagen as a sort of scaffold or structure for the cartilage to growth along and form into. This will be a Collagen Type I and Collagen Type II layer. one over the other. One of the layers will be hard and dense, while the other is less hard.
6. Inject the growth factors.
7. Put a brace over the fracture to hold it in place. Similar to the ilizarove method. Wait until the bones fuse with the newly grown cartilage.
8. Once they are fused, you have to do physical therapy to make sure that the newly formed cartilage layer can deal with the weight loading when the entire human weight is applied to it. Over time the growth factors are continuously added to the cartilage region.
This is going to another one of those posts that I realize I am going to continuously edit upon to revise and make better. I really do believe that we already have the technology to increase height using a faster, less invasive, and better way to increase height through non-limb lengthening methods.
Update 1: We should also add the use of LIPUS into the method. Also, it is found that BMP6 and BMP9 may be slightly better than BMP2 and BMP7 on certain parts.