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HyProCure: The lifetime solution for talotarsal dislocation and its devastating effects.

The HyProCure stent represents a real solution for talotarsal dislocation and its devastating effects throughout the body. It instantly corrects the problem at its root cause and immediately works on improving and even reversing many of the symptoms and secondary conditions resulting from this common deformity. These include flat feet, overpronation, plantar fasciitis or heel pain, knee pain, hip pain, back pain, and many others, both in children and adults.

In order to understand this breakthrough solution, let's first take a look at the problem. Talotarsal dislocation occurs when the ankle bone (talus) displaces off of it's natural alignment in it's articulation with the hind-foot, ankle and heel bones, called the sinus tarsi. The sinus tarsi is at the apex of the foot's ability to distribute weight and motion evenly, and when it collapses, the foot twists into an unnatural position and shape, creating an imbalance throughout the entire body.

HyProCure is an internal stabilization device that is placed inside the foot, right into the collapsing space. It acts as a stent to keep the space in its natural, open position. Immediately upon placement of stent, the ankle and hind-foot bones will be situated into their proper alignment. The procedure instantly stabilizes and re-aligns the hind-foot, which in turn also helps to correct the imbalances created in the rest of the body.
The HyProCure stent is simply pushed into place, there is no bone drilling or screwing involved. Thanks to its unique, anatomical design, the HyProCure device slides right into its natural corrective placement where the tissues inside the space will attach and hold it in place during the healing process.
The procedure is minimally invasive and it's usually performed under local anesthesia or twilight sedation. Full recovery to experience all the benefits varies from patient to patient. Typically most patients are back to normal walking within a few weeks although it can vary from foot to foot and person to person.

Who Needs This?
If you or someone close to you suffers from the symptoms or secondary conditions caused by talotarsal dislocation. The HyProCure procedure should be strongly considered as early a possible. The longer the condition is present, the more problematic the symptoms throughout the body can become. Take a look at our symptoms and secondary conditions page to learn if talotarsal dislocation is affecting your life, and learn how HyProCure can restore your quality of life by resolving the problem at its root.

How to know if you are a candidate.
In principle, anyone older than 3 years of age suffered from the effects of talotarsal dislocation can and should be considered for the HyProCure procedure. The requirement is that the individual has a flexible deformity versus a rigid one. This can be determined by moving the foot and artificially holding back the ankle bone into its normal position on the hind-foot bones. If able to do so, then the HyProCure procedure is possible. If the ankle bone can be repositioned back to its normal alignment on the hind-foot bones, then HyProCure can be inserted to maintain alignment. Fortunately, the vast majority of people suffering from talotarsal dislocation do indeed have a flexible deformity and are perfect candidates to benefit from the HyProCure solution. However, the longer this deformity goes untreated, the more likely it is to become a rigid, non-reducible deformity.

Additional considerations
It is often possible that other deformities, such as deviated metatarsal bones, ligamentous or tendon laxity or contractures, can be present which may or may not need to be addressed along with the HyProCure procedure. Your podiatric foot and ankle specialist will be able to determine this during your examination.

Who isn't a candidate?
Some people may have a partially flexible or rigid deformity. Unfortunately, these patients are not good candidates to benefit from HyProCure, because their feet lack the necessary flexibility to adopt the corrected shape. These patients will need other types of treatment in order to improve their condition.

Life after HyProCure: The immediate changes
Instantly following the HyProCure procedure, your ankle bone is stabilized. Your arch may be more prominent and the overall anatomy of your foot will be improved. You should be able to gently step on that foot, but will need to be careful and could benefit from the use of a cane or crutches for a few days.
Over the first several days, there will be some swelling and bruising. The amount of post-procedure pain will vary from foot to foot, and patient to patient, and is managed with anti-inflammatory and pain medications prescribed by your podiatric surgeon. It is also very possible to have a period of abnormal walking while your foot adapts to its new, corrected position. Initially, it will feel as if you are walking on the outside of your foot. This is expected, subconsciously your body will want to guard your foot since it just underwent a surgical procedure. This is only temporary. As the healing continues, you will eventually walk more naturally on the bottom of your foot.
After the first couple of weeks, most of the initial discomfort will have greatly diminished and most patients begin to walk more normally. It is important to still be very gentle on that foot since the tissues are still tender from the procedure. It is imperative that you DO NOT wear your previous shoes as they are worn-out due to your previous faulty foot structure. It is crucial that you wear brand new shoes. The number one reason for pain after the first few weeks is due to stress from bad shoes.

The long-term benefits
Four to six weeks after the procedure, the tissues are continuing to heal. Most patients are now walking very normally and activity levels can be gradually increased. The chance of displacement after this point is very rare.
The bones, tendons and ligaments throughout your foot and the rest of your body will continue to adapt to the new position over the following several months. Improvement will be gradual and consistent and can take months or years to fully recover from the abuse placed on them. It is during this time that most patients begin to feel relief from the many symptoms affecting them. These are very happy months, as you likely begin to feel your knee pain, hip pain, back pain, and many other symptoms decrease and possibly eventually disappear, depending on their severity.
After the first year, your body has typically fully adapted to the new position and your quality of life has officially improved.

Understanding talotarsal dislocation:
What is talotarsal dislocation?

Talotarsal dislocation is a common condition affecting millions of people of all ages throughout the world. It occurs when the ankle bone displaces off of its normal position and its contact points on the hind-foot bones - in other words, when the balance of the ankle bone on the heel bone is lost. This creates an abnormal, inward rotation of the ankle bone and outer rotation of the rest of the foot, which in turn creates a fundamental imbalance of forces and weight distribution both in the foot itself, as well as in the rest of the body.
This displacement can be either total or partial. While a total dislocation is rare and usually results only from severe trauma and requires extensive treatment, partial dislocation is much more common and it is present at birth.
In addition, the condition can be either dynamic or static. Dynamic dislocation means that with no weight on the foot, the ankle and heel bones are in normal alignment, but as soon as weight is placed on the foot, the ankle bone slips out of alignment. Static dislocation means that the ankle bone is permanently displaced and fixed into an abnormal alignment at all times.
The use of the term talotarsal dislocation in this website refers to a dynamic partial dislocation of the talus on the tarsal mechanism, which is the most common and most treatable type.

What are the direct effects of this condition?
When talotarsal dislocation occurs, it creates a damaging misalignment of forces both in the foot itself, as well as throughout the entire body. This is because the rear-foot is the center point of our body's balance and weight distribution during walking and standing. As a consequence, talotarsal dislocation can be the direct cause of numerous foot ailments, including flat feet, plantar fasciitis or heel pain, overpronation, bunions heel spurs, and more - as well as the direct cause of symptoms in the rest of the body such as knee pain, hip pain, back pain and even complications in the neck and shoulders.
Talotarsal dislocation will not resolve on its own, patients don't grow out of it, and it's not possible to reverse it through exercise or physical therapies. The many treatments commonly used to address the symptoms of this condition merely deal with the side effects and they do not resolve the root of the problem.
HyProCure represents a real solution for many patients suffering from the devastating effects resulting from talotarsal dislocation, and a real opportunity to improve their quality of life.

The latest article that has been accepted for publication on this procedure is titled "Radiographic Evaluation of Navicular Position in the Sagittal Plane-Correction following an Extraosseous Talotarsal Stabilization Procedure," The abstract is now available for review at the following link: http://www.jfas.org/article/S1067-2516(11)00206-7/abstract


Dr. Craig H. Thomajan
Founder and Managing Partner of Austin Foot and Ankle Specialists