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A. HyProCure is placed within the orientation of the sinus tarsi, which is anterior lateral distal to posterior medial proximal, not lateral to medial. Therefore, the HyProCure stent prevents the slipping of the talus off the posterior facet and the talus can perform its heliocoidal motion to transfer the weight of the body to the calcaneus and navicular bones. Devices placed lateral to medial act by blocking the lateral process of the talus leading to potential bone deformation. The true talar stabilization occurs right at the cruciate pivot point of Farabeuf. The tapered portion of HyProCure, the middle of the device, is placed right at this cruciate pivot point, providing stability to the STJ complex, whereas in competitive devices only the leading edge is placed at this essential location.

A. It appears that you did not do anything wrong. Every sinus tarsi has a variable alignment from one foot to the other and from one patient to the other. Some feet have an extremely oblique sinus tarsi while others are more lateral to medial. Just as long as the HyProCure stent is centered under the talus and correction is maintained, there is nothing to be concerned about.

A. I would not be too concerned as HyProCure is simply pushed into the sinus tarsi and we are at the mercy of the soft tissues and osseous structures to hold it in place until the tissues adhere to the device. After placing HyProCure in the foot and upon weightbearing it is possible for the stent to “seek its own level”. We need to remember that this is not a screw anchored into a bone so slight displacement can and will occur. Just as long as the correction is maintained and the patient isn’t experiencing pain out of proportion then I would just leave it alone. However, if there is loss of correction or the patient feels the stent is clicking or popping then a revision may be required.