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[Megatron]

Anyone know how long it would take in most cases where everything goes according to plan and lengthening is done at an average rate to reach the point where you can weight bear slightly to fully with the precise nail if lengthening to 8 cm, when you'll be able to walk without assistance, have a normal normal gait, drive a vehicle for a short period of time to a ling period?

[Michael J. Assayag, MD]

You will start walking assisted around 4-4.5 months.

walking unassisted by 6 months.

I have patients drive by 3.5 months  when they don’t take any narcotics and their reflexes are back .
normal gait may take up to a year, but this is not specific to PRECICE

[Stretch]

Hello Dr Assayag

Throughout the time leading up to the 4-4.5 months would patients be solely bound to a wheelchair or is the use of a walker with wheels be permitted?

If your body weight was within the safe region would using the larger of the two precise nails (10.7-12.5mm) eliminate the use of a wheelchair at any point throughout the process?

[Michael J. Assayag, MD]

Hello Dr Assayag

Throughout the time leading up to the 4-4.5 months would patients be solely bound to a wheelchair or is the use of a walker with wheels be permitted?

If your body weight was within the safe region would using the larger of the two precise nails (10.7-12.5mm) eliminate the use of a wheelchair at any point throughout the process?

some standing is allowed but no walking really.

It will break either the mechanism or break the rod.

Unless you weigh less than 75 pounds, no walking should be done during lengthening even with a rolling walker.

However Precice creates the best bone of all available internal lengthening devices and is the only one that can be reversed to compress.

[Stretch]

some standing is allowed but no walking really.

It will break either the mechanism or break the rod.

Unless you weigh less than 75 pounds, no walking should be done during lengthening even with a rolling walker.

However Precice creates the best bone of all available internal lengthening devices and is the only one that can be reversed to compress.

Thank you for your response.

I now see why the Stryde nail was so popular.

[Apollo676]

some standing is allowed but no walking really.

It will break either the mechanism or break the rod.

Unless you weigh less than 75 pounds, no walking should be done during lengthening even with a rolling walker.

However Precice creates the best bone of all available internal lengthening devices and is the only one that can be reversed to compress.

That part really interest me,i've read that precice seems to be even better than stryde,like comfort and pain wise,like the only drawback is the non weight bearing of precice,can you confirm that ? That Precice is similar or even better than stryde for the distraction process in term of comfort for the patient and long term recovery ?
Thanks doc

[Michael J. Assayag, MD]

That part really interest me,i've read that precice seems to be even better than stryde,like comfort and pain wise,like the only drawback is the non weight bearing of precice,can you confirm that ? That Precice is similar or even better than stryde for the distraction process in term of comfort for the patient and long term recovery ?
Thanks doc

Precice and stryde have the same mechanism. The only difference was material.

Stryde was too stiff and shielded the bone from load and function.

My patients are in general much happier with Precice than they were with stryde.

[Want-3-inches]

My patients are in general much happier with Precice than they were with stryde.

  How so? Most Stryde patients faced no symptoms of osteolysis and were very happy to be weight bearing from the beginning. Some even managed to go to office during lengthening.

[Michael J. Assayag, MD]

  How so? Most Stryde patients faced no symptoms of osteolysis and were very happy to be weight bearing from the beginning. Some even managed to go to office during lengthening.

Precice creates better regenerate, less long term (12-18 months) pain, much less implant related complications.

You’d be surprised the amount of patients I get from all over the Us and europe and even my practice with broken nails, broken pegs, poor bone regenerate with stryde.

[Stretch]

Precice creates better regenerate, less long term (12-18 months) pain, much less implant related complications.

You’d be surprised the amount of patients I get from all over the Us and europe and even my practice with broken nails, broken pegs, poor bone regenerate with stryde.

Wow that is surprising!

Precise sounds more reliable indeed. The only downside I can see is the weight bearing considerations, it sucks

Dr Assayag

I’ve read previously your take on LON Femur but at this time the only other internal nail other then P2 that is still used is the mechanical/ratchet nail “Betz/Gnail” variations. What is your take on this nail if any as it has quite a lot of traction throughout Europe clinics as its “weight bearing”?

[Michael J. Assayag, MD]

Wow that is surprising!

Precise sounds more reliable indeed. The only downside I can see is the weight bearing considerations, it sucks

Dr Assayag

I’ve read previously your take on LON Femur but at this time the only other internal nail other then P2 that is still used is the mechanical/ratchet nail “Betz/Gnail” variations. What is your take on this nail if any as it has quite a lot of traction throughout Europe clinics as its “weight bearing”?

I wish I could give you an honest opinion on those but I really have no experience with the Albizzia mechanical nail variations.

we shall see !

[Stretch]

Thank you again Dr Assayag.

[pownzorgeek]

I wish I could give you an honest opinion on those but I really have no experience with the Albizzia mechanical nail variations.

we shall see !

Hello Dr. Assayag,

just a question: If I am about 60kg (132 pounds) pre surgery, would I be able to use a walker?

Would I be able to stand (for example to wash teeth or any other such task)? Or is that more a "it depends" question?

[V21]

I think that, now that Stryde is gone, mechanical nails must be considered as a good option. I'm a current G Nail patient with Giotikas, 5 weeks post op. While the experience has been pretty painful, I am walking since day one, and I feel very happy about my choice. And also important: I seem to be very unlucky, cause the other patients did not have as much pain clicking as I had. We all have quite good bone formation too.

[Michael J. Assayag, MD]

Hello Dr. Assayag,

just a question: If I am about 60kg (132 pounds) pre surgery, would I be able to use a walker?

Would I be able to stand (for example to wash teeth or any other such task)? Or is that more a "it depends" question?

with 12.5 nails you would be able to stand.

walking is not recommended

[Want-3-inches]

I wish I could give you an honest opinion on those but I really have no experience with the Albizzia mechanical nail variations.

we shall see !

Why haven't they ever had FDA approval in the US? Do you know the history?

[kobeisdagoat24]

You will start walking assisted around 4-4.5 months.

walking unassisted by 6 months.

I have patients drive by 3.5 months  when they don’t take any narcotics and their reflexes are back .
normal gait may take up to a year, but this is not specific to PRECICE

Hi Dr,

What is the ETA on when you will be able to lift weights? Specifically upper body

[Michael J. Assayag, MD]

upper body right from the beginning. Just modify your exercises not to have to bear weight on your legs

[SirStretchAlot]

Why haven't they ever had FDA approval in the US? Do you know the history?

1) Since they do not perform any operations in the US, why bother?

2) The clicking pain complication which I experienced too will have to be fixed. Doesn't seem solvable as Betz and Guichet have been at it for decades.

[Megatron]

You will start walking assisted around 4-4.5 months.

walking unassisted by 6 months.

I have patients drive by 3.5 months  when they don’t take any narcotics and their reflexes are back .
normal gait may take up to a year, but this is not specific to PRECICE

Thanks Dr. Assayag, didnt know you were on this forum but thats cool that you are. Im currently waiting for stryde because i dont want to miss too much time from work. I work two jobs. One that is an office job and another that requires me to be on my feet. I would be okay with at least getting back to the one where i can just drive to my office and work. I also rather not tell my parents about this procedure til after its done so they dont worry which is why i want a normal gait. How long would you say in comparison to the stryde nail would the precise 2 take to get a normal gait, be able to star walking unassisted. really just trying to figure out a timetable to get back to working and a normal walk before i can get back to my normal life. Dont want anyone asking questions about what happened to me.

[pownzorgeek]

with 12.5 nails you would be able to stand.

walking is not recommended

Thank you for the answer. Do you perhaps know or have heard anything about when Precice will be available again in the EU?

[ChangeMyLife]

Dr. A, can one stand for a few minutes with 10.7mm at 160lbs?

[George119]

Dr A thank you for all of this information!

If you don’t mind my asking, with Precice 2.2 can people apply some weight to their legs while transitioning around from wheelchair to bed/toilet/car on a transfer board?

Thank you

[Siegfried]

Its has been available in the EU, since a few days. Im finally having surgery on friday.

[indication]

Its has been available in the EU, since a few days. Im finally having surgery on friday.

wooo 'grats man!

Which doctor? Giotikas? And femurs right? Are you gonna write a diary?

[Michael J. Assayag, MD]

Dr. A, can one stand for a few minutes with 10.7mm at 160lbs?

only with 60pounds arm assistance

[pownzorgeek]

Its has been available in the EU, since a few days. Im finally having surgery on friday.

Hi, that's really good news. Did Giotikas or some other doctor tell you? It would be awesome to get an official source confirming it.

[ChangeMyLife]

only with 60pounds arm assistance

In that case, how would they do chores like brushing their teeth, general activities near a bathroom sink, and carrying small things like food while moving around? This is a detail that's always evaded me.

[indication]

In that case, how would they do chores like brushing their teeth, general activities near a bathroom sink, and carrying small things like food while moving around? This is a detail that's always evaded me.

Excellent question. I think about this a lot!

[Ismail6024]

Very interesting Dr Assayag thank you, I assumed you could walk without looking ‘strange’ at 6 months but, you are saying up to one year after surgery, so I guess I will have to tKe out 1 year?

[EndGame]

In that case, how would they do chores like brushing their teeth, general activities near a bathroom sink, and carrying small things like food while moving around? This is a detail that's always evaded me.

Those things are done the same way anyone who is wheelchair bound does them lol. There are hotels with lowered sinks etc handicap accessible rooms I think they are called. I stayed at one when doing precise femurs with Paley. Life sucks in a wheelchair but it's totally doable.