Research
Overview of Published Studies
![](https://www.grahamiii.com/wp-content/uploads/2017/01/Extra-osseousTalotarsalStabilizationDevices.jpg)
Extra-osseous Talotarsal Stabilization Devices: A New Classification System J Foot & Ankle Surgery – (52) 2012, 613-619.
Sinus tarsi implants are not all the same.
Type II (HyProCure®) is a superior design and function when compared to Type I arthroereisis devices.
Surgeons and patients must understand the differences between the 2 types.
Type II (HyProCure®) has a superior success rate over Type I arthroereisis devices.
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Computed Tomography Review of Tarsal Canal Anatomy with Reference to the Fitting of Sinus Tarsi Implants in the Tarsal Canal. J Foot & Ankle Surgery – 52 (2013) 714 – 716
Anchoring stem of the HyProCure sinus tarsi implant extending into the canalis tarsi is unlikely to bear any weight.
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Stabilization of Joint Forces of the Subtalar Complex via HyProCure Sinus Tarsi Stent. J American Podiatric Medical Association 101 (5) 2011 390 – 399
- Subtalar joint instability leads to increased forces acting anteriomedially.
- HyProCure® stabilized the talus on the calcaneus keeping the joints in constant congruent contact.
- Forces acting on the medial column of the foot are reduced with HyProCure®
- Patients who have symptoms to medial column related tissues/structures should be evaluated for subtalar joint instability and HyProCure has been proven to stabilize the joint and normalize joint forces.
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Effect of Extra-osseous Talotarsal Stabilization on Posterior Tibial Tendon Strain in Hyperpronating Feet. J Foot & Ankle Surgery, 50 (2011) 676-681.
- RTTJD leads to increased strain on the posterior tibial tendon and it can be named as an underlying etiologic factor to the development of PTTD.
- HyProCure® is proven to stabilize the talotarsal joint.
- HyProCure® can reduce the pathologic strain on the posterior tibial tendon by 51%.
- Patients who have symptoms associated with their posterior tibial tendon should be evaluated for talotarsal joint displacement and HyProCure® should be considered apart of the treatment solution.
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Evaluating Plantar Fascia Strain in Hyperpronating Cadaveric Feet Following an Extra-osseous TaloTarsal Stabilization Procedure. J Foot & Ankle Surgery (50) 2011, 682-686.
- Primary factor to the underlying etiology of plantar fasciopathy is mechanical overloading of the plantar fascia.
- Talotarsal joint displacement directly increases the strain to the medial band of the plantar fascia.
- HyProCure® stabilizes the talotarsal joint and decreases the strain on the plantar fascia by an average of 33%.
- Patients with chronic heel pain must be evaluated for talotarsal joint instability.
- HyProCure® is a proven solution to address the underlying etiology to plantar fasciopathy.
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The Effect of HyProCure® on Tarsal Tunnel Compartment Pressures in Hyperpronating Feet. J Foot and Ankle Surgery, (50) 2011, 44-49.
- EOTTS with HyProCure stabilizes the talotarsal joint, decreasing the pressures within both the tarsal tunnel and porta pedis.
- This could help to reduce the symptoms associated with posterior tibial neuropathy and tarsal tunnel syndrome.
- EOTTS with HyProCure® could be performed as a primary intervention or in combination with tarsal tunnel/porta pedis decompression surgery.
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Effect of Extra-osseous Talotarsal Stabilization on Posterior Tibial Nerve Strain in Hyperpronating Feet: A Cadaveric Evaluation. J Foot Ankle Surgery, (50) 2011, 672 – 675.
- RTTJD leads to pathologic increased pressures on the posterior tibial nerve within the tarsal tunnel and porta pedis.
- RTTJD also leads to an elongation and increased strain on the posterior tibial nerve.
- Stabilization of the TTJ with HyProCure® has proven to significantly decrease/normalize both elongation and strain on the nerve.
- EOTTS-HyProCure® offers a proven rational in the treatment of plantar foot neuropathy
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Radiographic Evaluation of Navicular Position in the Sagittal Plane – Correction Following an Extra-osseous TaloTarsal Stabilization Procedure. J Foot and Ankle Surgery, (50) 2011, 551-557.
- HyProCure® was effective in reducing navicular sag by 26%.
- This is very significant as there is not a single case study showing a similar or greater finding with the use of an arch support (over-the-counter or custom made).
- This data plays a critical role in the treatment of medial column instability and shows that HyProCure® is an excellent option in the treatment of arch instability, when indicated.
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Surgical Treatment of Hyperpronation Using an Extra-osseous Talotarsal Stabilization Device: Radiographic Outcomes in Adult Patients. J Foot and Ankle Surgery, (51) 2012, 548-555.
- Transverse and sagittal plane normalization with HyProCure® as a stand alone procedure is proven via weightbearing radiographic evidence in adult patients.
- Average and maximum guidelines on the amount of expected correction is provided.
![](https://www.grahamiii.com/wp-content/uploads/2017/01/PlantarPressureDistributioninaHyperpronatedFoot.jpg)
Plantar Pressure Distribution in a Hyperpronated Foot before and after Intervention with an Extraosseous Talotarsal Stabilization Device – A Retrospective Study. J Foot Ankle Surgery – 52 (2013) 432-443.
- There is a direct link between RTTJD and pathology plantar foot forces.
- EOTTS-HyProCure® has been proven to normalize pathologic plantar foot forces
- Patients with plantar skin pathology should be evaluate for RTTJD and HyProCure should be considered a part of the treatment solution.
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Extra-osseous TaloTarsal Stabilization using HyProCure® in Adults: A 5 year Retrospective follow up. J Foot & Ankle Surgery (51) 2012, 23-29.
- HyProCure® has been proven to have the highest success rate over any other EOTTS device.
- HyProCure® has the lowest removal rate over any EOTTS device (6% compared to 38% to 100% of arthroereisis devices).
- Even though there were removals and/or revisions there were no long-term complications.
- Not a single patient/foot developed chronic pain post-HyProCure® removal.
- Patients who required a revision went on to a successful outcome.
- HyProCure® is a safe and effective option for adult patients with recurrently talotarsal dislocation, when indicated.
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Analysis of Radiographic Outcomes Comparing Foot Orthosis to Extra-osseous Talotarsal Stabilization in the Treatment of Recurrent Talotarsal Joint Dislocation. J Minimally Invasive Orthopedics – January 2015
- EOTTS-HyProCure® is a very effective form of treatment to realign and stabilize RTTJD.
- Orthosis are ineffective in the realignment and stabilization of RTTJD
- EOTTS is a superior option over an arch supports/orthosis in realigning and stabilizing the TTJ.