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[Kintaeryos]

With Precise Max finally coming out, it got me wondering how much room is left for LL to get safer and easier. Are there any open areas of research left, ideas that are yet to be tried etc. or has it pretty much reached its limits as a whole (i.e. the basic mechanism of bone-lengthening has been fully understood and exploited and there isn't much more to do with it), and all that's going to happen now is small incremental improvements like higher weight bearing capacity, stronger nails that won't corrode or bend etc.? Just some extra bonuses to make it a bit more convenient, but nothing groundbreaking that will significantly change how it's done or reduce the risks and inconvenience to normal plastic surgery levels?

[Body Builder]

For at least the next 2 decades the max we can anticipate is just some small improvements in full weight bearing nails and the best is some price reduction if we have more than 2 nails like these in the market but I highly doubt it.
Nothing else.
After all, 70 years till the introduction of Ilizarovs the principles of this procedure remain the same. So nothing major is to be expected at least till most of us are still in a suitable age for LL (up to about 50yo).

[GrowGrow123]

I think it is maxed out. At this point, the mechanism for osteogenesis is pretty much perfected. Most of the improvements will likely be improvements to the weight bearing capabilities and stability of the nail going forward.

However, the hard part of LL is the soft tissue. Getting the tendons, muscles, and nerves to all stretch and adapt. There really isn't much the nail itself can do to improve this aspect.

[finertoga]

Nobody knows. People can make the best predictions based on the information that is available to them and the current state of the technology, but even the top futurists and smartest minds have been dead wrong before when it comes to science and tech. I’m sure the other posters in this thread know quite a bit about distraction osteogenesis and LL technology, but I would take any answer with a large grain of salt. They could be completely right that there will be limited improvement, or there could be a major breakthrough that changes things forever. No one knows

[Kintaeryos]

Nobody knows. People can make the best predictions based on the information that is available to them and the current state of the technology, but even the top futurists and smartest minds have been dead wrong before when it comes to science and tech. I’m sure the other posters in this thread know quite a bit about distraction osteogenesis and LL technology, but I would take any answer with a large grain of salt. They could be completely right that there will be limited improvement, or there could be a major breakthrough that changes things forever. No one knows

After some thought I think LL will continue to get safer and better, but not because of any major changes to it specifically, but medical technology in general advancing and as a byproduct that helping LL. One major problem with medicine is that a lot of aspects of the human body cannot be modeled with 100% accuracy, so doctors just monitor you, see what symptoms you exhibit and only after the fact know what to do, the human body is sometimes treated as a "black box" and all doctors can do is control the input based on its output. For example fat embolisms are hard to anticipate cause the circulatory system is huge and complex, too multivariate and chaotic to 100% monitor in every detail, they only know you're experiencing one after it's happening. Same with strokes, heart attacks etc. Plus they have no way of predicting if your physiology is such that it will happen. But if medical monitoring technology advances to the point where your entire body can be 100% modeled, analyzed and monitored, they can account for everything.

[TheDream]

Maybe the distraction method could be improved for internal nails. Like right now it’s just small discrete steps that add up to like 0.75-1.00 mm a day. Each of these discrete steps causes a jump in pressure on the soft tissue.

If we could monitor the pressure on the soft tissue somehow, and use this to do the distraction smarter it could help maybe. The distraction steps could maybe be done even smaller at a time and perhaps while you are sleeping to mimic the natural growing cycle, if this helps.

Just my ideas. I dont know how far out this would be though. Improvements in LL seem to very slow and mostly seems to be Paley and his team who push for innovation. The rest seem happy just working with existing stuff.