A Closer Look At An Emerging Sinus Tarsi Implant
When an implant offers benefits such as less traumatic insertion, no post-op casting and minimal post-op recovery time, it may be worthwhile to consider such an implant for the correction of hyperpronation. The HyProCure Sinus Tarsi Implant offers a minimally invasive surgical remedy for hyperpronation, according to Gramedica, the manufacturer of the device. The company says the implant facilitates accurate placement and less traumatic insertion than other implants. When it comes to treating patients who present with hyperpronation, Benjamin Weaver, DPM, has found “a significant increase” of positive results in those who were treated with the HyProCure implant in comparison to patients treated with orthotics. Whereas other implants may not be indicated for children or certain geriatric patients, Dr. Weaver notes that surgeons can perform the minimally invasive HyProCure implant procedure for patients ranging in age from 3 or 4 years old to 100 years old. “This procedure truly benefits all age ranges,” maintains Dr. Weaver, who is in private practice at Central Kansas Podiatry Associates in Wichita, Kan. Emphasizing The Unique Aspects Of The HyProCure Implant Gramedica says the implant procedure only requires one small incision, which is usually less than 1 inch. The company adds that post-op casting is not necessary and that there are no limitations to activity once the implant site has healed. Dr. Weaver says there is minimal scarring with the HyProCure implant and, in his experience with the implant, the healing time ranges between two to five weeks, depending upon the patient. The HyProCure implant is less traumatic to the bony structures of the sinus tarsi versus other subtalar implants, according to Dr. Weaver. “One reason I was more interested in this product is because it is held in with soft tissue and not the bone,” points out Dr. Weaver. “Other implants screw into the bone and if the implant has to be removed, we cannot always fix it as easily. This implant can be removed or one can reverse the procedure if the patient does not like it.” A Couple Of Caveats To Keep In Mind In order to achieve optimal outcomes, Dr. Weaver says surgeons must perform a full release of the interosseous ligament between the talus and calcaneus. “Otherwise, any strands left in place once the stent is implanted act like a rubber band and sometimes eject the implant,” cautions Dr. Weaver. He adds that there is a learning curve with performing the HyProCure implant procedure as “the implant does not insert lateral to medial perpendicular like typical subtalar implants.” Dr. Weaver says the learning curve also applies to those who undergo this procedure as they have to alter how they are used to walking. “Most people are used to walking on the medial side of their foot for so long that when their foot is supinated, the lateral side of their foot gets very sore,” notes Dr. Weaver. “They are not used to pushing off with their hallux or a propulsive gait.” However, Dr. Weaver notes that as long as the patient follows postoperative instructions on the implant, he or she can “quickly adjust” to a new way of walking. Final Notes Gramedica says surgeons can perform the procedure for the HyProCure implant in less than 10 minutes with the patient under local anesthesia. Gramedica says rigid or semi-rigid deformity is a contraindication for the HyProCure implant. The company also encourages surgeons to obtain radiographic evaluation of patient bone. Dr. Weaver concurs and says one should not perform the procedure on patients with an immature skeletal system, those with osteoporosis or those with a severely arthritic foot.