Methods and 360°+ Care

We invite you to visit our clinic in Warsaw or schedule an online consultation.
This is the most important first step, during which we’ll make sure you feel safe and are fully informed from the very beginning.

What can you expect during your visit?

• Team of Experts: You will meet one of our lead physicians (Dr. Mike or Dr. Tom) and your team of physical therapists.
• Diagnosis and Medical History: We will conduct a thorough examination to assess the actual length of your limbs, take X-rays (if available on-site), review your medical history, and evaluate the proportions of your femurs and tibias, as well as the degree of valgus and varus deformities in your limbs. If you have your own X-rays, please bring them with you.
• Education and Planning: We will explain the lengthening (distraction) process in detail for each available method, discussing the growth rate (from 1 mm to 1.5 mm per day) and the consolidation phase, i.e., the mineralization of bone tissue. We will conduct a detailed interview with you about your lifestyle (stimulants, supplements, physical fitness).
• Customized quote: After a detailed discussion of the surgical procedure, an analysis of your X-rays, and the selection of the optimal treatment method tailored to your anatomy, you will receive a quote for the entire lengthening process from us. This quote will be sent to you by Ola (Ms. Alexandra), your patient coordinator.

Once you’ve made your initial decision, we invite you to visit the Institute—
’s Paley Lengthening Center. This visit may take up to a full day, as we want to devote as much time to you as you need. You’ll meet our team in person and get to know the Institute and its surroundings.

What can you expect during your visit?

• Comprehensive diagnostics: We will take detailed X-rays (if we did not do so during the initial consultation). This will allow us to thoroughly assess your anatomy and precisely plan every step of the treatment process.
• Complete transparency and time for questions: We’ll set aside time for an open conversation with the attending physicians. We will answer absolutely every one of your questions. We will thoroughly discuss all stages of the procedure, the expected duration of treatment, total costsso that you have a clear understanding of the situation. We will discuss potential complications and provide instructions on how to prepare your body for this process several months in advance.
• Preoperative Appointment Schedule: We will provide you with a detailed list of preoperative appointments. These are dedicated sessions during which we work together, step by step, to safely prepare your body and mind for the upcoming surgery.
• Education and Our Team: Learn more about our Institute and dedicated team of physical therapistswho will be with you every day after your surgery. We’ll explain how your rehabilitation will proceed over the coming months. You’ll take a tour of the clinic and the hospital, during which you’ll meet the people ensuring your comfort: Alina and Kasia (Alina & Kate) from the hospital coordination department.
• Patient Care: You will meet Ola (Ms. Alexandra), your personal care coordinator, who will ensure your comfort, handle the logistics, and help you efficiently navigate all organizational
  and administrative matters. You can book transportation with us at this stage.
• The Town of Wilanów: Discover Wilanów Town: a prestigious location recognized for its innovative architecture and urban planning (including the prestigious ULI Global Award for Excellence 2010). Wilanów Town offers access to numerous cafes, restaurants, and recreational areas, which helps foster a positive mindset before the procedure and provides a comfortable environment throughout the entire process.

This is a crucial time during which we not only prepare your body for the procedure, but also lay the groundwork for your safety. Over the course of two weeks, you’ll work closely with our team to ensure you’re fully informed and physically ready to begin the lengthening process.

• Intensive physical therapy: We carefully prepare your body for the challenge ahead. As your bones lengthen, your soft tissues will be stretched, and your muscles will become very tense. Building up the necessary flexibility and strength beforehand will make post-operative exercises much easier for you. You will also learn movement patterns that you will use daily during treatment to effectively prevent permanent contractures.
• Accommodations: We can help you rent comfortable apartments right next to the clinic. We want to ensure that, during this challenging time, you have the peace of mind and a home-like environment right next to the place where you’ll be spending time with our physical therapists.
• Transportation: We coordinate transportation to the institute, ensuring smooth and safe travel at every stage.

After the surgery, you will remain under the constant care of qualified medical staff and your dedicated physical therapist. Your hospital stay will be brief, typically lasting two nights. Following the procedure, we will ensure that your pain is kept to a minimum, allowing you to get moving quickly and begin the recovery process.

Postoperative care in the hospital:

• Thromboprophylaxis: We take care of your circulation by using mechanical compression pumps and oral blood-thinning medications, which help prevent blood clots.
• Comfort and Safety: Physical therapists ensure your body is properly positioned to keep you comfortable and prevent pressure sores. You’ll receive a wheelchair and an automatic splint to help you regain mobility in your limbs more quickly. We’ll provide you with detailed instructions and show you how to manage on your own safely during the first few days after surgery.
• Monitoring of vital signs: We perform routine blood tests to respond promptly to your body’s needs and ensure your complete safety.
• 24/7 Medical Support: You’ll receive a direct WhatsApp contact for your doctor’s surgical assistant. In case of medical emergencies after you’re discharged from the hospital, Sebastian is at your complete disposal 24 hours a day, 7 days a week, giving you the utmost peace of mind.
• Early rehabilitation: While still in the hospital, you’ll learn how the limb-lengthening device works, the basics of care, and begin mobilization exercises—the first exercises you’ll do twice a day with your physical therapist.

Physical therapy is a key factor in ensuring the success of your treatment, your future mobility, and minimizing the risk of complications. During the distraction (lengthening) phase, daily sessions with a therapist are required (5 days a week).

The Paley European Institute stands out from other centers by having an on-site specialized rehabilitation unit, whose team follows the global limb-lengthening physical therapy protocol developed by the Paley Institute in Florida, created by Dr. Dror Paley.

Why is our rehabilitation program unique?

• Comprehensive Care from A to Z: We work with you from the very first days after surgery, and our mission doesn’t end when the pin is removed. Intensive rehabilitation takes much longer—we stay with you until you achieve 100% safe mobility and complete independence in your daily life.
• Modern tools: Anti-gravity treadmill, normobaric chamber, a Pilates reformer, and a dedicated gym help you return to full fitness faster after surgery. In addition to inpatient care, you receive access to a platform with personalized exercise plans, allowing you to continue your own training.
• Personalized Approach: Every day, our therapists work with patients of all ages who have undergone limb-lengthening surgery, allowing us to tailor individualized exercise plans to maximize muscle strength and flexibility and prevent complications in each case.
• Experience in rare diseases: We draw on our unique orthopedic expertise to provide world-class care.

You'll receive a Welcome Pack from us that will motivate you to get even more done :)

The rehabilitation program includes:

• Rehabilitation during the distraction phase: Intensive exercises designed to counteract soft tissue tightness and prevent contractures in the hip, knee, and ankle joints.
• Weight-bearing exercise: Applying controlled weight under the supervision of a specialist, which stimulates bone tissue to mineralize and remodel more quickly.
• Prevention of complications: Continuous monitoring of range of motion to prevent joint stiffness and secondary deformities.
• Training and instruction: Learning how to use the systems (e.g., PRECICE, LON) and the guidelines for caring for surgical sites.
• Post-operative care: Full support after the cast is removed, including assistance in selecting and learning to walk in orthoses, which protects the new bone tissue from injury.

The final step, taken after the new bone tissue (regenerate) has fully healed and you have returned to your normal activities, is the removal of the PRECICE nails (at an additional cost) or the external fixator and intramedullary nail (included in the lengthening procedure).

Implant removal procedure:

• PRECICE System: We remove magnetic nails located inside the bone. This is typically a one-time procedure performed after the bone has fully healed.
• The LON Method – Stage 1: The external stabilizer is removed almost immediately after the distraction phase is completed.
• The LON Method – Stage 2: The intramedullary nail, which stabilizes the bone during healing, is removed at a later date, once the bone has fully remodeled and is strong.
• Comfort and recovery: The procedure is minimally invasive and performed on an outpatient basis (without an overnight hospital stay).