For DPMs dealing with the common condition of hyperpronation, the HyProCure^™ Sinus Tarsi Implant may be one of the more intriguing treatment options to date.
Composed of medical grade titanium, the implant serves as an internal orthotic that essentially turns the negative space of the sinus tarsi into a positive space, according to the implant’s manufacturer Gramedica.
Gramedica says the HyProCure implant is stronger than bone and requires one small incision for insertion without the need for casting after the procedure. Paul Clint Jones, DPM, has successfully implanted the HyProCure device in about 20 patients since 2006. “I have used the older generation products and none of them are able to be used and tolerated the way HyProCure is,” states Dr. Jones, who practices in Spokane, Wa., and Kellogg, Idaho.

A Closer Look At Key Benefits

While medication, physical therapy and orthotics can address the symptoms of hyperpronation, Gramedica says these treatment options do not target the underlying cause. Historically, the use of implants to target the problem has also been problematic.
“The older generation of STJ implants has a poor track record of not being tolerated and having to be removed in the adult population,” notes Dr. Jones. “(The) end result is having to do more aggressive procedures with increased risk, protracted convalescence and pain to the patient.”
Using the HyProCure implant enables surgeons to avoid these issues, according to Dr. Jones. Gramedica maintains that surgeons have successfully used the HyProCure design since 2004 to realign the talus on the calcaneus.
For Dr. Jones, one of the key benefits of the HyProCure is that it “addresses the apex of the deformity of the foot.” He says this allows for a broader spectrum of indications. Dr. Jones also points out that surgeons can use the implant to treat both adults and pediatric patients.
The company says the ease of insertion makes the HyProCure stent an attractive option for practitioners. A 1.5- to 2.0-cm incision over the sinus tarsi is usually all that is necessary to implant the device. The goal of the procedure is to achieve 1 to 3 degrees of rearfoot eversion and the stent is available in several sizes to achieve this goal, according to Gramedica.
In addition, Gramedica says the implant will not wear out, patients are usually back in regular shoes within one week of surgery and there are no limits to activities once the implant is inserted and healing has occurred.

Some Caveats To Keep In Mind

Gramedica notes there are potential complications with this procedure. One rare complication that surgeons have observed is “sprained ankle syndrome,” due to the new stretch being placed on the outer ankle ligaments. The company says this may be a temporary symptom that will likely dissipate. However, if the ligaments do not adjust to the new positioning, Gramedica says this may require removal of the implant.
Depending on the amount of correction one achieves with the implant, postoperative pain may also be present. Anti-inflammatory medication is recommended for six to eight weeks after the procedure to reduce discomfort, according to Gramedica.

Final Notes

Overall, Dr. Jones says the design of the HyProCure implant and the ease of the procedure facilitates optimal results.
“This product bridges the need to deliver the best service to my patients while minimizing the worry that I could have done something more,” emphasizes Dr. Jones.