Precise Max nail pricing?

Edit Post

safe, less pain and less complications ofc

Edit Post

Quote from: JustineCollins on January 15, 2024, 05:02:00 AMsafe, less pain and less complications ofc
Yeah, but the price of a sports car or apartment? What is it about LL specifically that necessitates such a price?

Edit Post

According to Paley the most experienced surgeon in the world who has helped developed it, it has already been tested to withstand much more force and proved to be fully weightbearing. The FDA are only giving those guidelines to save their unnecessarily careful, So yeah worth the wait of a couple of months in the US and 1-2 years in Europe. You will most likely be able to walk after days instead of months with a lower complication risk. Only downside is 10% exstra cost however for that price small increase its a nobrainer!!

Edit Post

Quote from: Kintaeryos on January 15, 2024, 08:41:40 AMYeah, but the price of a sports car or apartment? What is it about LL specifically that necessitates such a price?

It's a niche surgery, companies do not produce hundreds of thousands of nails every year. So to make a profit they need to make it expensive. The same goes for the doctors, Paley do not do hundreds of CLL surgeries every year and he wants to make at least a couple million a year to make his time going through medical school, residency and decades of experience worth it.

Internal LL will only get considerably cheaper if they start a mass production of a good quality internal nail in a cheaper country.

Edit Post

Quote from: DanishViking on January 15, 2024, 09:19:23 AMAccording to Paley the most experienced surgeon in the world who has helped developed it, it has already been tested to withstand much more force and proved to be fully weightbearing. The FDA are only giving those guidelines to save their unnecessarily careful, So yeah worth the wait of a couple of months in the US and 1-2 years in Europe. You will most likely be able to walk after days instead of months with a lower complication risk. Only downside is 10% exstra cost however for that price small increase its a nobrainer!!

Perhaps you are correct. But I also wouldn't get my hopes up too high until this nail has been adequately tested. It is important to remember that Precice Max is made of titanium. Stryde's durability and ability to allow full-weight bearing was due to it being made of stainless steel alloy. Precice Max is still made of titanium, just like its non weight-bearing counterpart Precice 2.2.

So it is unclear if a titanium nail will ever be designated fully weight-bearing (like Stryde) was. I can understand why the FDA is hesitant to label it as such. Of course, patients and surgeons can proceed with caution and allow their patients to fully weight bear (at their own risk). However, there is risk of nail bending in those cases. Nail bending should be avoided because it could carry all sorts of poor consequences (and extra costs) for the patient.

So yes, I am curious what the studies will show, but Precice Max doesn't seem like it is currently equivalent/ superior to Stryde (which I used in 2019 for my femur lengthening and I thought Stryde was a terrific nail).

 Hopefully, with time, we can feel safe/ secure knowing that Precice Max has been proven to be a fully weight-bearing solution, despite it being made of titanium.

Edit Post

Pmax is not fully weight bearing unless you can fit the 13mm or 14mm nails. The 11.5mm and the smallest (10.7mm?) are about the same weight bearing as p2.2 12.5mm. Paley had a good slide in his presentation comparing pMax and p2.2 at various diameters. Anyway, no one should get their hopes up until their consult and they find out based on EOS X-rays what diameter nail will fit their bones.

Edit Post

Its not true in the live episode with Cyborg4life, he is telling in detail how it's only guidelines and how even the 10 mm nail will be able to weightbear probably around 150 lbs pr nail. See here at 28:00 - 32:30 / the test that already been done and 36:50 his telling what he will most likely end up recommending in the future. Please don't spread misinformation...

Edit Post

Look around 35:47 in the video and you'll see the weight bearing test results. P2.2 12.5mm about the same as pMax 10 and 11.5mm. You've never done LL, likely never will, and you post things that are often wrong or misleading. Perhaps take your own advice and stop posting misinformation? I posted in this thread primarily because your misinformation and prevent your confusion spreading lol.  Since I'm going back for another LL I followed up with Paley Institute right after that interview. Dr. Robbins was very clear that patients around my weight with 10 or 11.5mm pMax will not be allowed to walk without using their arms and walker to de weight. Yes, the FDA 50lbs max weight bearing is only a guideline and safe per Paley to do more but that's a far cry from fully weight bearing at 10mm nail for all or even most patients. There's also a difference between fully weight bearing as in you can stand balanced weight equal across both legs and fully weight bearing as in you can safely walk around with just a cane. Please stop spreading misinformation...

Edit Post

Quote from: EndGame on January 16, 2024, 08:27:31 PMLook around 35:47 in the video and you'll see the weight bearing test results. P2.2 12.5mm about the same as pMax 10 and 11.5mm. You've never done LL, likely never will, and you post things that are often wrong or misleading. Perhaps take your own advice and stop posting misinformation? I posted in this thread primarily because your misinformation and prevent your confusion spreading lol.  Since I'm going back for another LL I followed up with Paley Institute right after that interview. Dr. Robbins was very clear that patients around my weight with 10 or 11.5mm pMax will not be allowed to walk without using their arms and walker to de weight. Yes, the FDA 50lbs max weight bearing is only a guideline and safe per Paley to do more but that's a far cry from fully weight bearing at 10mm nail for all or even most patients. There's also a difference between fully weight bearing as in you can stand balanced weight equal across both legs and fully weight bearing as in you can safely walk around with just a cane. Please stop spreading misinformation...


Terrific post, EndGame. Good clarification and level of detail

Edit Post

Quote from: EndGame on January 16, 2024, 08:27:31 PMLook around 35:47 in the video and you'll see the weight bearing test results. P2.2 12.5mm about the same as pMax 10 and 11.5mm.

But why are you comparing the 12.5 mm from P2.2 with the 10 mm from Pmax? Isn’t that the entire point?

That most short people won’t be able to fit a 12.5 mm precise 2.2 rod so now with the Pmax they get 190 lbs (86 kg) fatigue load per rod at 10 mm instead of the current Precise 2.2 84 lbs (38 kg) fatigue load per 8.5 mm rod or 118 lbs (53 kg) fatigue load per 10.7 mm rod?

For the 12.5 mm precise 2.2 rod the fatigue load was 191 lbs (87 kg) while for the Precise max at 13 mm which is the comparable size it is now 320 lbs (145 kg) fatigue load.