HyProCure is an implant placed in the sinus tarsi between the talus and calcaneus bones to stabilize the talar bone and prevent excessive motion of the hindfoot bones. It transforms the closed sinus tarsi space back into its normal open space, reducing abnormal forces on soft tissues. By stabilizing this talo-tarsal joint mechanism, it can help address secondary issues throughout the body caused by the excessive hindfoot motion like plantar fasciitis, tibial tendon issues, and knee or hip problems. It has been used in over 10,000 procedures since being FDA approved in 2004.

1. What is HyProCure®? www.hyprocure.com

2. HyProCure Internal Extra-osseous Extra-articular Talar stabilization stent www.hyprocure.com

3. HyProCure - Internal HyProCure is placed beneath the neck of the ankle bone (talus) to stabilize its triplane plane motion on the hindfoot bones (calcaneus & navicular) or tarsal mechanism. HyProCure is always working, unlike external devices such as arch supports/orthotics, braces, and splints. www.hyprocure.com

4. HyProCureInternal Permanent Solution www.hyprocure.com

5. HyProCure – Extra-osseous HyProCure is placed in between 2 bones (talus & calcaneus). It is not inserted into any bone. HyProCure is placed into a naturally open area (sinus) that is formed by the undersurface of the talus and upper surface of the calcaneus (heel bone). www.hyprocure.com

6. HyProCure – Extra-articular HyProCure is placed in between joints but NOT into a joint. It is not placed into a joint-very important point. There is no cartilage within the open space where HyProCure is placed only soft tissues. www.hyprocure.com

7. HyProCure – Talar Stabilization Talus/Talar is the ankle bone. HyProCure prevents the partial dislocation of the talus on the calcaneus (heel bone). This prevents excessive abnormal motion of the hindfoot bones. www.hyprocure.com

8. TaloTarsal Joint The ankle bone (talus/talar/talo) forms 4 joints with the hindfoot bones- calcaneus and navicular (tarsal bones). The motion of the talus on the hindfoot bones must be considered as 1 functional unit. www.hyprocure.com

9. TaloTarsal Mechanism 4 separate articulations acting as 1 physical unit 3 bones Completely unique joint configurations Triplane motion: Supination/Pronation Malposition of one facet = malposition of the other 3 facets. Bottom of the talus www.hyprocure.com

10. Normal Alignment The talus is supposed to sit on top of the calcaneus. Each half the joint should be in constant contact. Canal/sinus (Sinus Tarsi) in between the two bones should always be “open”. Sinus tarsi www.hyprocure.com

11. TaloTarsal Dislocation-Partial When the talus slips off its normal position on the calcaneus this closes (obliterates) the sinus tarsi and leads to excessive abnormal motion to the hindfoot and places an excessive strain on the supporting soft tissues (ligaments and tendons). www.hyprocure.com

12. So What Does HyProCure Fix? www.hyprocure.com

13. HyProCure stabilizes the Talus HyProCure transforms the closed space of the sinus tarsi back into its normal “open” space. It prevents the excessive abnormal motion of the hindfoot. This also decreases the excessive abnormal forces acting on the soft tissues. www.hyprocure.com

14. Why is talar stabilization important? www.hyprocure.com

15. If there is a recurrent partial dislocation of the talus on the tarsal mechanism… …with every step taken and while standing there are excessive strains placed on the joints, soft tissues, and bony structures not only affecting the foot but there can be a negative impact on the legs, knees, hips, pelvis, shoulder, neck and skull. This leads to: TaloTarsal Dislocation Syndrome. www.hyprocure.com

16. TaloTarsal Dislocation Syndrome These are the “effects” from the “cause”. Scientific literature has long recognized the fact that excessive/hypermobile hindfoot is the lead cause of many deformities of the musculoskeletal system. If we stabilize the hindfoot (talotarsal mechanism) then we can reduce/eliminate these secondary conditions. www.hyprocure.com

17. TaloTarsal Dislocation leads to… Soft Tissue Strain on the Plantar fascia Posterior Tibial Tendon Tarsal Tunnel Posterior Tibial Nerve Bone deformities 1st ray deformities Hallux limitis Tailor’s bunionette Navicular drop/sag Adductovarus toes Flexor stabilization hammer toes Biomechanical problems. Heel valgus Abductory twist “too many toes” sign Posterior Tibial Nerve

18. There is a chain reaction due to the talus slipping off its normal alignment. www.hyprocure.com

19. 2 Weeks Post-OpThe Knees

20. If we stabilize the TTM than we can also help the rest of the body. www.hyprocure.com

21. We are not saying: That we can cure foot, knee, leg, hip, pelvic, back, shoulder, or neck deformities with HyProCure. However, we are saying that by reducing the excessive motion and strain to the rest of the body many times these symptoms are either reduce or completely eliminated. If you fix the “cause” than the “effects” should disappear. www.hyprocure.com

22. HyProCure History FDA 510(k) approval 2004 As of December 31st 2010- Over 10,000 have been placed nationally and internationally combined. Used by both podiatric and orthopedic foot surgeons, globally.

23. Why HyProCure? There are many “subtalar” implants available, however, HyProCure is completely unique. HyProCure functions in a completely different fashion, is placed deeper than any other device, and has the best anatomic fit. There is a difference. For more information search “Why HyProCure” www.hyprocure.com

24. “Changing Lives, One Step at a Time” www.hyprocure.com