EOTTS with HyProCure
What Is It?
EOTTS (Extra-Osseous TaloTarsal Stabilization) is a conservative surgical option to internally realign and stabilize the talus without limiting or blocking normal TTJ ROM. HyProCure is a small titanium stent that is placed into a naturally-occurring space in between the ankle bone and heel bone through a small incision below the outer ankle bone. FDA cleared since 2004, HyProCure has been used by foot and ankle specialists in nearly 60 countries.
If you have flat feet and other treatment options have not worked, you should learn about HyProCure a minimally invasive surgery offered here at Hicksville Podiatry in Hicksville, NY. This procedure is quick and simple. Click the button to make an appointment to learn more and see if this procedure is right for you!
Why Is HyProCure Effective?
Unlike orthotics, EOTTS with HyProCure is an internal permanent solution and functions with or without shoes. As opposed to reconstructive surgery, there are no pins, screws, or drills required. Post-op recovery time is significantly less. EOTTS with HyProCure is also reversible. Because of its positioning in the sinus tarsi, it has a significantly lower displacement rate than arthroereisis devices. As it is not a joint blocking device, it allows for full range of motion.
Available Treatment Options
This is a non-treatment option. The excessive abnormal forces continue to place damage distally and proximally. Hindfoot alignment will not auto-correct.
Why isn’t it effective?
Observation is not a form of treatment. It is simply doing nothing while the existing problem becomes worse. Misaligned feet are caused by an internal structural problems with the talus and calcaneus. The problem will not fix itself and will only continue to get worse over time
2. Arch Supports & Foot orthotics
What is it? Arch supports are inserts that are placed inside the shoe and are normally used to restore a fallen arch and cushion the bottom of the foot.
Why it isn’t effective?
While arch supports and foot orthotics may temporarily alleviate pain and may be useful for some foot pathologies, they are placed below the calcaneus and cannot realign or stabilize the talus. Like glasses, they only work when you wear them and give a false sense of correction. There are no studies that show that an arch support can realign and stabilize the talus on the calcaneus. Overall, orthotics are supportive at best, but not corrective enough. Despite with the orthotics, misaligned feet will get worse over the time with abnormal forces are still acting on the feet, knees, hips and back.
3. Reconstructive Surgery
What is it? There are patients whose only option is traditional reconstructive surgery. These are joint destructive procedures and should only be used for a complex deformity.
Why it isn’t effective?
While it can be effective for severe foot pathologies, reconstructive surgery is often too aggressive for patients with mild to moderate TTJD. It involves large incisions, a long recovery process and many potential complications. These procedures cannot be reverse.
This is a joint destructive, irreversible option. The cure may be worse than the problem. This surgery involves a long recovery time with many potential complications. Some patients require additional surgery to revise and/or remove internal hardware.
Common Patient Questions
Will I feel the implant in my foot?
As long as the implant does not displace, you should not be able to feel HyProCure after the procedure. Sometimes for the first few months, a hard substance may be felt in the area of the surgery. This is scar tissue and should dissipate after several months, if present at all.
Will there be a visible scar?
The incision is less than an inch long and located below the outer ankle bone. With time, the scar will continue to fade. Results vary for each patient.
Will this implant get rid of all of the pains in my body?
No one can completely predict the outcome of any surgical procedure, but this solution should help improve the entire body’s alignment. Therefore, reduction and relief of pain caused by the foot imbalance will also be reduced or eliminated. However, it is possible that some of the joints and soft tissues in the body may have already suffered irreversible wear and tear, and in those cases other treatments or procedures might be necessary. In either case, correcting the root of the problem is still essential to stopping any further damage and to allowing for any additional therapies (if necessary) to be long lasting.
Will I still have to wear my orthotics after the procedure?
There are other reasons for orthotics to be worn. Orthotics can be used to off-weight prominent areas to the bottom of the foot. If those areas are not surgically addressed, then orthotics may still be required after the procedure.
Are there limitations to this procedure?
Yes, every surgical procedure has its limitations. In very severe cases of talotarsal displacement, other surgical procedures may be necessary to achieve optimum correction. There are no guarantees with any surgical procedure. It is possible that even an ideal HyProCure candidate will have to have the stent removed. Weight or BMI is not a factor in patient selection.
Do both feet need to be realigned for EOTTS with HyProCure to be effective?
Yes, both feet need to be stabilized. You can compare it to the tires on your car. You wouldn’t balance the tires on only on side of your car. This would have a negative impact on your alignment. It is the same as stabilizing only one foot. However, it is generally recommended to correct one foot at a time, when possible.
Is there drilling or screwing involved in the procedure?
There is no drilling or screwing involved with the EOTTS with HyProCure procedure. A small incision is made in the skin over the sinus tarsi. The stent simply slides into the natural space inside the foot. The threads on the stent are only to allow the scar tissue to form around the grooves and lock the device in place during the normal healing process.
As far as sports and physical activity go, are there limitations after the procedure?
Once the tissues surrounding the stent are healed, there should be no limitation. The abnormal motion is no longer present. Usually, there is a significant improvement in running, jumping, and activity involving propulsion from the foot.
Can I still get MRIs, CT Scans, etc with HyProCure in my foot?
Yes. HyproCure is made from medical-grade titanium. However, as with any procedural implant, you should inform your doctors of the implant and follow their recommendations.
If this procedure is performed on a child, does it have to be replaced later in life?
The short answer is likely no, but this is not a guarantee. Normally, once the stent is inserted into the foot, it rarely has to be changed. The bones will continue to grow peripherally around the HyProCure stent. Time has shown that if the most common adult size is placed into a child’s foot, then it is unlikely it will have to be replaced upon osseous maturity.
What are the chances of having an allergic reaction to this implant?
Titanium is the choice material used in the body since it is the least reactive. HyProCure is made entirely of medical-grade titanium. Some patients develop what appears to be an allergic reaction, but this could be the result of a pre-existing chronic inflammation of the foot (synovitis).
How soon can a HyProCure recipient return to sports, running or jogging?
It will take a minimum of 4 to 6 weeks for the HyProCure stent to become anchored within the sinus tarsi. Displacement rarely occurs after 6 weeks, therefore running or jogging should not be attempted until 6 weeks after the procedure. Ultimately, the final clearance comes from the foot surgeon.
After the EOTTS with the HyProCure procedure, will I need to be pre-medicated prior to dental treatment or other future surgical procedures?
You should not need to pre-medicate prior to dental or other surgical procedures because the HyProCure stent is not embedded into the bone. Of course, there are other reasons to require pre-medication. Check with your healthcare provider.
Will HyProCure stent set off metal detector?
No. HyProCure is made of titanium and won’t set off metal detectors.