Extra-Osseous TaloTarsal Stabilization using HyProCure® in Adults:                     A 5-Year Retrospective Follow-up   ...
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5 Year Retrospective Analysis of the HyProCure Talotarsal Fixation Device


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5 Year Retrospective Analysis of the HyProCure Talotarsal Fixation Device

  1. 1. Extra-Osseous TaloTarsal Stabilization using HyProCure® in Adults: A 5-Year Retrospective Follow-up Journal of Foot and Ankle Surgery, Volume 51, Issue 1, Pages 23-29, January 2012 Michael E. Graham, DPM, FACFAS, Nikhil T. Jawrani, MS, Avanthi Chikka, MSPurpose  The mean age at the time of surgery was 58 (range 22 to 85) years.The purpose of this clinical investigation was to evaluate  The average follow-up was 51 months post-operative.postoperative subjective outcome measures of the  Patients were asked to provide honest responses toHyProCure® extra-osseous talotarsal stabilization the Maryland Foot Score Questionnaire. The(EOTTS) device as a standalone procedure in a assessment asked patients to evaluate outcomes inrandomized adult population treated for symptoms three key areas – pain, foot function and footassociated with recurrent and flexible talotarsal joint appearance.dislocation.Background HyProCure® has a less than 6%The stability of the talotarsal joint is crucial to maintainproper balance, uniform weight distribution, normal gait removal rate and is highly effective inpattern, and biomechanical function, not only for thefoot and ankle but also for the proximal musculoskeletal the treatment of talotarsal dislocationstructures (knee, pelvis, and spine). Abnormal forceswithin the talotarsal joint lead to excessive hindfoot (partial) as a stand-alone procedure.motion, which results in a prolonged period andexcessive amount of pronation during static and dynamicweight-bearing activities. It has been recommended that Clinical Significance & Conclusionsinterventions that reduce or eliminate excessive  Patient satisfaction scores showed excellent long-pronation should be considered. Subtalar arthroereisis, a term results, with a high level of tolerability andsurgical procedure that lifts the talus and blocks the overall improvement in the quality of life of theanterior lateral process, has been used to treat this patients. The average total score was 88 out of 100.condition since the 1960s. However, clinical outcomes  In each category, the majority of patients chose theof this procedure have historical been less-than-optimal, highest possible satisfaction rating; 52% reportedwith reported removal rates of around 40%. complete alleviation of foot pain, 69% had noHyProCure® is designed to restore, as close as possible, limitations on their foot’s functional abilities andthe normal articular relationships of the talotarsal joint 80% reported complete satisfaction with thewithout compromising the normal range of hindfoot appearance of their foot.motion and provides correction in all three cardinal  The implant removal rate was less than 6% (5.94),planes of foot motion. which is significantly lower than reported rates of arthroereisis devices (average 40% removal rate). TheMethods low removal rate and minimal postoperative  Eighty-three adult patients (minimum age of 18 years complications are attributed to the unique design and at the time of surgery) on whom the HyProCure® insertion properties of HyProCure®. procedure was performed between October 2004 and  This study shows the use of the HyProCure® EOTTS December 2006 participated in this study (117 feet). device is tolerated with minimal risk and high patient  Exclusion criteria for the study included patients who satisfaction and a significantly lower removal rate had received HyProCure® in conjunction with than arthroereisis devices. hindfoot/midfoot osseous procedures or soft tissue procedures that may aid in the correction of talotarsal instability. 68% of patients had no other procedures performed. Additional Scientific Papers on HyProCure® are available. Visit the Library section on: www.GraMedica.com