Updating the tech? You make it sound like it's supposed to work. Too much tech gets in the way of drama and character. Simple ia always better and less is always more. The so called future tech of Enterprise will be laughable tomorrow as it is even today. Nothing stays the same and the things of today will probably be gone tomorrow in favor of something we can't possibly concieve of today. To me TOS was the most possible and plausible future of them all. GR's imagination was not less plausible than ours is.
It's still a show set in the future, you cannot have a future that ignores technological advances that have taken place in the present. Tech that will have advanced in the future you are portraying. Tech getting in the way? That's up to the writers and producers to ensure it doesn't, but it needs to be there and they have to get it right.
Stem cell treatments would have come in handy in the future don't you think? Will trek ignore it forever just because the original show from the 1960s had no idea it would ever exist?