Weight Bearing — The Biggest Practical Difference
Weight bearing is arguably the most impactful upgrade in Precice Max. With Precice 2, patients must follow strict partial weight-bearing protocols throughout the lengthening phase. This means relying heavily on walkers and crutches, with limited ability to put full pressure on the operated leg.
Precice Max's thicker titanium wall and larger diameter (up to 14 mm) allow the nail to tolerate significantly more mechanical load. Patients can transition toward full weight bearing earlier — which means faster rehabilitation, better muscle preservation, and a greater sense of independence during what is already a demanding recovery process. For heavier patients in particular, this is a critical advantage.
| Precice Max Nail Diameter | Weight Bearing (lbs) | Weight Bearing (kg) |
|---|---|---|
| 10 mm | 150 lbs | 68 kg |
| 11.5 mm | 200 lbs | 91 kg |
| 13 mm | 250 lbs | 113 kg |
| 14 mm | 250 lbs | 113 kg |
Note: The appropriate nail diameter is determined by the dimensions of the patient's intramedullary canal. Dr. Huseyin Kavak selects the optimal size during your pre-operative evaluation.
Comfort & Daily Life
Both Precice 2 and Precice Max are fully internal — no external fixators, no pins through the skin, no visible hardware. In terms of discretion and daily comfort, both systems are in the same category and far superior to LON or Ilizarov methods.
However, Precice Max's improved weight-bearing capacity has a downstream effect on comfort. Patients who can bear more weight earlier tend to sleep better, move more confidently, and experience less overall frustration during the lengthening phase. The difference is not dramatic in the first weeks, but becomes increasingly noticeable as the lengthening progresses.
Material — Stainless Steel vs Titanium
Precice 2 is constructed from stainless steel, a material with a long track record in orthopedic implants. It is strong, cost-effective, and well understood by surgeons worldwide.
Precice Max uses a titanium alloy — a material that offers improved biocompatibility, lighter weight, and greater resistance to corrosion. Titanium is also the reason behind Pmax's improved MRI compatibility, as it produces fewer artifacts on magnetic resonance imaging compared to stainless steel. For patients who may need MRI scans during or after their lengthening treatment, this material change is clinically significant.
Infection Risk & Scarring
Both systems carry a very low infection risk because there are no external pins creating open wound sites. Scarring is also minimal for both — a single small incision near the hip or knee. In these categories, there is no meaningful difference between Precice 2 and Precice Max. Both are excellent.
MRI Compatibility
Precice 2 has conditional MRI compatibility — meaning imaging is possible in certain conditions but with limitations. Precice Max improves on this with an updated design that broadens MRI compatibility. This matters for patients who may need diagnostic imaging for unrelated health conditions while the nail is still implanted, which can be up to 1–2 years post-surgery.
Control Mechanism
Both systems use the same ERC (External Remote Controller) — a handheld magnetic device that activates the internal nail from outside the body. The patient performs three daily sessions, each extending the bone by approximately 0.33 mm. The process is identical for both Precice 2 and Precice Max. However, the stronger magnetic motor in Precice Max delivers more consistent and reliable activation, particularly in patients with more soft tissue between the skin and the nail.
Cost Difference
Precice Max is more expensive than Precice 2. The higher cost reflects the re-engineered titanium construction, stronger motor, and newer manufacturing process. The exact price difference varies by clinic and country.
At UpRise, both methods are available with transparent, all-inclusive pricing. Whether the additional investment in Precice Max is worthwhile depends on your individual priorities — particularly around weight bearing and earlier mobilization. Dr. Huseyin Kavak provides a personalized recommendation during your consultation based on your anatomy, weight, lifestyle, and budget. View our Precice Max cost details.
Availability
Precice 2 has been available globally for over a decade and is offered by limb lengthening surgeons worldwide. Precice Max is significantly newer — FDA-cleared in late 2023 — and availability remains limited. Not all surgeons or clinics have access to the Pmax system yet. At UpRise in Istanbul, Dr. Huseyin Kavak offers both Precice 2 and Precice Max, ensuring patients can access whichever system best suits their needs.
