HyProCure: Addressing Common Concerns and Myths
HyProCure is an advanced, effective, and minimally invasive procedure that can provide a permanent solution for feet that have been misaligned by talotarsal displacement—and, by extension, the many secondary complications that arise from it.
We’ve written about it here many, many times.
That said, as with any specialized medical procedure, there are often may questions, concerns, and even misconceptions surrounding it.
That’s okay! We encourage all our patients to ask questions about their condition and the treatments we recommend and provide. We want you to be comfortable with the direction of your care, and the only way to do that is through communication, understanding, and truth.
That’s why we also wrote this blog, addressing some of the most common myths and concerns we’ve heard. We hope you find it helpful.
Is This an Experimental Treatment?
In fact, sinus tarsi implants like HyProCure have been used to treat misaligned hindfeet for decades. HyProCure itself has been FDA-approved in the United States for more than 15 years, has been widely used by clinicians here and in over 60 countries worldwide, and has a solid record of safety and success.
Sinus tarsi stents work. There are dozens of peer-reviewed studies and thousands of happy patients to prove it.
So, Are All Sinus Tarsi Implants the Same?
Broadly speaking, there are three types of sinus tarsi implants used by doctors worldwide:
- Intra-osseous—the stent is drilled into the hindfoot bones.
- Extra-osseous, arthrodesis—the stent is placed between the bones, on the outer half of the naturally occurring space (sinus tarsi)
- Extra-osseous, non-arthrodesis—the stent is placed between the bones, but much deeper within the sinus tarsi.
HyProCure fits into the third category, which works by enabling natural motion of the ankle (as opposed to blocking motion of the ankle). It provides greater benefit with fewer risks than other types of procedures.
It also specifically has some unique design features that make it much more reliable than comparable treatments (which we’ll get into in a minute).
Won’t the Stent Grind Against the Bones or Impair the Joint? Will It Lead to Arthritis?
As mentioned above, the HyProCure stent is placed within the naturally occurring sinus tarsi space between the ankle bone and heel bone. The sinus tarsi itself is not a joint and is not to be confused with the subtalar joint, and does not contain cartilage.
If the bones are aligned correctly, the sinus tarsi is stable and not supposed to collapse or get compressed. With HyProCure, the sinus tarsi can hold its shape and allow the subtalar joint to work and move as intended.
HyProCure will not get in the way of your bones. On the contrary, it stops them from getting in the way of each other!
If you suffer from talotarsal displacement, not getting HyProCure is the surest way to guarantee the eventual destruction of the joint.
Can the Stent Get Displaced?
It’s technically possible, but extremely rare, for a couple of reasons.
First, because of the size of the stent and its depth and position within the sinus tarsi, it’s much less likely to get displaced than an “arthrodesis” stent that’s only placed within the outer half of the space.
Second, because the HyProCure stent features a specially designed, threaded barrel, it quickly “locks” into place after insertion. Once scar tissue builds up around the stent, and the interosseous ligament heals around the threads, it becomes very difficult to budge.
It’s important to clarify here that, despite the threaded barrel, the HyProCure stent is not “screwed in” to your foot. It is pushed straight in. The threads just keep it from moving as the tissues heal.
What Happens if It Gets Displaced or Doesn’t Work?
Unlike more conventional reconstructive surgeries which involve cutting and reshaping bones, a HyProCure procedure is fully reversible. So if for any reason the procedure needs to be adjusted or re-performed, it can be easily done by a trained professional.
But to be clear, this is rarely ever required. And in fact, HyProCure has the overall highest success rate and lowest risk of ever needing to be removed or replaced of all currently available sinus tarsi stent treatments available. The overall removal rate is just 6%.
Is HyProCure Only for Flat Fleet?
It would be more accurate to say that HyProCure is designed to stop the ankle bone from falling forward, becoming misaligned, and collapsing the sinus tarsi—the aforementioned talotarsal displacement.
Flat feet are an extremely common consequence of talotarsal displacement, but not the only one—and not present in every case. Other symptoms that may appear in addition to (or instead of) flat feet include bunions, hammertoes, heel pain, knee pain, back pain and others.
Furthermore, not every case of flatfoot is the result of talotarsal displacement. In other words, we’ll have to examine your feet carefully to determine the ultimate cause of your condition, as well as the most appropriate treatment options.
Why Wouldn’t I Just Get Orthotics Instead?
Custom orthotics are one possible alternative to HyProCure for misaligned feet, and one that we do often prescribe for our patients.
The advantage of orthotics is that they are completely non-invasive and, if carefully selected and worn faithfully, they can often alleviate any painful problems resulting from your misaligned feet.
However, there are also drawbacks. Orthotics need to be worn at all times to provide any benefit, which means you’ll either need multiple pairs or have to switch them from shoes to shoes. They wear out over time, too, and need to be adjusted or replaced regularly.
Most notably, though, orthotics won’t ever actually fix or correct your foot misalignment. They’ll just support and stabilize you while you wear them. HyProCure, on the other hand, offers the possibility of a permanent fix in a single appointment.
A useful analogy would be eye care. Orthotics are like wearing glasses or contacts all day, every day. HyProCure is like LASIK. It’s about accommodating the problem versus actually fixing it.
Is It Safe for Kids? Won’t They Outgrow Their Misaligned Feet?
Some forms of childhood flat feet do tend to self-correct over time. However, this is not always the case. And in fact, misaligned or flat feet related to talotarsal displacement are unlikely to self-correct, and more likely to lead to long-term pain throughout the legs and back in adulthood.
HyProCure, fortunately, is safe to perform on children—even those who are still growing. You might think that your child would physically outgrow the stent, but that’s actually not true. The “chamber” of the sinus tarsi (that is, the natural space into which the stent is inserted) matures at a very early age. In fact, already by age 3, it has reached adult size and strength, and thus can readily accommodate the procedure.
The ankle bone, heel bone, and surrounding structures will continue to grow and develop, and thanks to HyProCure they will be developing normally and in a way that no longer causes pain.
So, we would generally argue that the earlier misaligned feet are corrected, the better. No need to wait until 18, or any other arbitrarily defined age.
It is very unlikely that the stent would ever need to be removed or replaced even after reaching adulthood. And even if revision is needed, the procedure is once again easy to reverse.
Is It Safe for Someone with Diabetes?
Yes, it is. HyProCure has been performed on patients with diabetes successfully for more than a decade, with no indication that it puts them at elevated risk.
In fact, we’d honestly say that, rather than being a contraindication, a diabetes diagnosis might actually be all the more reason to consider this procedure.
A realigned hindfoot will minimize pressure spots along the sole, which reduces the risk of ulceration. It will also allow someone with diabetes to be more active and better control their blood sugar. When combined with other procedures, it may even significantly reduce your risk of developing Charcot foot.
Why Wouldn’t I Get a Traditional Reconstructive Surgery? Wouldn’t That Be Better?
There may be some instances where a more traditional reconstructive surgery would be a better option, or in fact the only option. That will depend on factors such as flexibility of the hindfoot and other considerations made by your surgeon.
However, if you are a good candidate for HyProCure, this tends to be the superior option for many reasons, including much lower risk of complications (infection, arthritis, nerve damage, etc.), much faster return to full weight bearing, and the fact that it’s fully reversible. And the long-term results are often equally good or better.
Ready to Learn More? Give Us a Call
We hope that the above information helped you put to rest any serious concerns or questions you may have had about this procedure. But if you have any other specific questions—and you’d like to explore whether HyProCure is right for you—we’d love the chance to examine your feet and talk to you in person about your treatment options.