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Changing Lives, One Step at a Time                           ®




    HyProCure® provides internal correction to stabilize
      excessive, abnormal motion of the hindfoot. It is
      placed via a brief, minimally invasive out-patient
     procedure and can be used in pediatric, adult and
   geriatric individuals. This is your guide to HyProCure.
“Wisdom comes from truth,
   truth comes from reality.”
                                                TaloTarsal Dislocation

“A foot divided against itself cannot stand.”
Normal                                                            Abnormal
                                                TaloTarsal Mechanism                                                TaloTarsal Dislocation
  “Wisdom comes from truth,
   truth comes from reality.”


                                                         A normal talotarsal mechanism is one in       Displacement (partial or complete) of
“A foot divided against itself cannot stand.”            which the articular facets of the talus are   the talar articular facets on the tarsal
                                                         aligned and remain in constant contact        mechanism indicates a pathologic
                                                         with the calcaneus and navicular. The         event. This is not a self-resolving
                                                         sinus tarsi, a naturally occuring space, is   deformity, it requires physical-
                                                         in the “open” poisition.                      physician intervention. This dynamic
                                                                                                       misalignment places excessive
                                                                                                       abnormal strain on the supporting
                                                                                                       structures of the foot and ankle.
“If you don’t know,
        you don’t see.
If you don’t see,                 TaloTarsal Dislocation Syndrome
        you don’t treat.                 Effects from the Cause

If you don’t treat,
        the problems continue.”
TaloTarsal Dislocation Syndrome                                           TaloTarsal Dislocation
                                                  Foot Implications                                                  Syndrome and the rest
                                  Soft Tissue Strain       Osseous Deformities                Pathomechanics         of the body
“If you don’t know,               Plantar Fasciopathy      Metatarsus Primus Varus/           Calcaneal Valgus
                                                                                                                     A dynamic chain reaction occurs when the talus
                                                                                                                     dislocates off its normal position on the tarsal
                                                           Hallux Abducto Valgus                                     mechanism.
        you don’t see.            Posterior Tibial
                                  Tendon Dysfunction       Hallux Limitus
                                                                                              Abductory Twist
                                                                                                                     There is loss of talotarsal height, which immediately
                                                                                              “Too Many Toes” Sign    pulls away the foundation from distal to proximal.
If you don’t see,                 Tarsal Tunnel Syndrome   Tailor’s Bunionette
                                                                                              Prolonged Pronation     The tibia twists abnormally on the femur, leading
                                  Tibialis Posterior       Navicular Drop/Sag
                                                                                                                      to knee strain and joint degeneration.
        you don’t treat.          Neuropathy
                                                           Adductovarus Toes
                                                                                                                      The head of the femur is pulled from the pelvis,
                                  Achillies Tendonitis
                                                                                                                     leading to hip symptoms.
If you don’t treat,                                        Flexor Stabilization Hammer Toes
                                                                                                                     The pelvis drops, leading to excessive tilt, which
        the problems continue.”                                                                                      immediately places tremendous strain on the
                                                                                                                     vertebrae of the lower and upper back.

                                                                                                                     This leads to shoulder tilt, which the neck tries to
                                                                                                                     compensate for, resulting in a twisting of the skull.

                                                                                                                     Finally, the mandible is misaligned leading to
                                                                                                                     excessive unilateral muscle contraction and TMJ
                                                                                                                     disorders.
“Simplicity is achieving
maximum results with
                           Internal Deformity = Internal Solution
   minimal effort.”
The Solution - HyProCure                                                          The Results - HyProCured
                           What is HyProCure? An extra-osseous, extra-articular, internal bone fixation device.




“Simplicity is achieving
maximum results with
   minimal effort.”
                             HyProCure – made entirely of medical grade titanium, is
                             simply pushed into the naturally occurring space between
                             the ankle and heel bone, once the joints are properly
                             realigned. The normal amount of motion is restored.

                             HyProCure offers the best anatomic design and bio-
                             mechanical function.
                                                                                                                  Before         After    Before      After
When external
measures are not
enough and
traditional
reconstructive         To learn more please visit
surgery is too
                        HyProCure.com
aggressive, think...
Indications:                                       Potential Complications:
  Obliteration (partial/full) of the sinus tarsi     Prolonged pain, edema, stiffness, discomfort
  Abnormal talar deviation on the calcaneus          and walking difficulty

  Flexible and reducible deformity                   Migration/Displacement of the device

  Older than 3 years of age                          Need for revision/removal of the device
                                                     Under/Overcorrection
Contra-Indications:                                  Synovitis/Bursitis
  Rigid non-reducible deformity                      Infection
  Less than 3 years of age                           Other risks associated with surgery
  Active local infection
  Very poor bone stock
Will I feel the device in my foot?
Frequenty Asked Questions:                                                                                         You should not be able to feel the device 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 over time.

                                                                                                                   Will there be a visible scar?
How do I know if I am a candidate for this procedure?                                                              The incision is rather small and located below the outer ankle bone. This part of the skin heals remarkably well.
There must be a flexible deformity. If the hindfoot can be manually positioned back to its normal alignment        Depending on your skin type, your scar should continue to fade and in some cases completely disappears.
then this should work, however, an examination by a foot specialist is required.
                                                                                                                   After the HyProCure procedure, will I need to be on antibiotics prior to dental treatment
Are there any limitations, as far as sports go, after this procedure?                                              or other future surgical procedures?
Once the tissues surrounding the device are healed, there should be no limitation. The abnormal motion is          Due to the size, position and location of the HyProCure device in the foot, there is no need to premedicate prior
no longer present and normal motion will occur. Usually, there is a significant improvement in walking,            to dental or other surgical procedures.
running and related activities.
                                                                                                                   Can I still get MRIs, CT scans, etc. with the device in my foot?
What are the chances of getting an allergic reaction to this device?                                               Yes, titanium is not reactive to these imaging modalities, unlike stainless steel, though there may be a “star-burst”
Titanium is the choice material to be used in the body since it is the least reactive.                             effect surrounding the device.

Does the device set off the metal detector at the airport?                                                         Will this device get rid of all of the pains in my body?
HyProCure is made of titanium and should not set off the metal detector at the airport.                            No one can predict the outcome of any surgical procedure, but it is a fact that this solution should improve your
                                                                                                                   body's alignment. As a result, reduction and relief of many pains caused by the foot imbalance will also be reduced
Should I have this surgery even though I don't have any symptoms?                                                  or eliminated. However, it is possible that some of the joints and soft tissues in the body may have already suffered
If a deformity is present, the sooner it is treated the less damage will occur. You don't want to wait for pain.   irreversible wear and tear, and in those cases other treatments or procedures might be necessary. In either case,
At that point, there may be irreversible damage. We don't wait until our car tires are worn to balance them.       correcting the root of the problem is still essential to stopping any further damage and to allow for any additional
                                                                                                                   therapies (if necessary) to be long lasting.
Is there drilling or bone cutting involved in this procedure?
The device is simply slid into the natural space inside the foot without any drilling or bone cutting involved.    Will I still have to wear arch supports after the procedure?
HyProCure is designed to maintain the natural space that already exists inside the foot, therefore no              Arch supports have a hard time stabilizing the ankle bone on the heel bone and if that was the sole reason to wear
invasive force is needed to insert it. The threads on the device allow the tissues to hold HyProCure in place.     the arch supports you shouldn’t need them anymore. On the other hand, there maybe other associated foot
                                                                                                                   deformities that may require the use of arch supports.
If this procedure is performed on a child, does it have to be replaced later in life?
Most likely not, it is intended to last for life.                                                                  What causes this condition?
                                                                                                                   It is most commonly caused by hereditary or genetic factors.
Do I need this procedure even if I have a mild case?
That depends. If you have symptoms and other forms of conservative therapy, including arch supports,               Are there limitations to this procedure?
haven't been able to provide you with relief, then this procedure may be helpful.                                  Yes, every surgical procedure has its limitations. In severe cases of dislocation, other surgical procedures may be
                                                                                                                   necessary to achieve optimal correction or possibly a combination of procedures.
GraMedica
        16137 Leone Drive
        Macomb, MI 48042

     Toll-free: 888.566.6459
      Phone: 586.677.9600

     www.HyProCure.com

                                      ®



               Made in the USA




© GraMedica 2011 HYP PT Cure / Rev. 05.15.11

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HyProCure Solution

  • 1.
  • 2. Changing Lives, One Step at a Time ® HyProCure® provides internal correction to stabilize excessive, abnormal motion of the hindfoot. It is placed via a brief, minimally invasive out-patient procedure and can be used in pediatric, adult and geriatric individuals. This is your guide to HyProCure.
  • 3. “Wisdom comes from truth, truth comes from reality.” TaloTarsal Dislocation “A foot divided against itself cannot stand.”
  • 4. Normal Abnormal TaloTarsal Mechanism TaloTarsal Dislocation “Wisdom comes from truth, truth comes from reality.” A normal talotarsal mechanism is one in Displacement (partial or complete) of “A foot divided against itself cannot stand.” which the articular facets of the talus are the talar articular facets on the tarsal aligned and remain in constant contact mechanism indicates a pathologic with the calcaneus and navicular. The event. This is not a self-resolving sinus tarsi, a naturally occuring space, is deformity, it requires physical- in the “open” poisition. physician intervention. This dynamic misalignment places excessive abnormal strain on the supporting structures of the foot and ankle.
  • 5. “If you don’t know, you don’t see. If you don’t see, TaloTarsal Dislocation Syndrome you don’t treat. Effects from the Cause If you don’t treat, the problems continue.”
  • 6. TaloTarsal Dislocation Syndrome TaloTarsal Dislocation Foot Implications Syndrome and the rest Soft Tissue Strain Osseous Deformities Pathomechanics of the body “If you don’t know, Plantar Fasciopathy Metatarsus Primus Varus/ Calcaneal Valgus A dynamic chain reaction occurs when the talus dislocates off its normal position on the tarsal Hallux Abducto Valgus mechanism. you don’t see. Posterior Tibial Tendon Dysfunction Hallux Limitus Abductory Twist There is loss of talotarsal height, which immediately “Too Many Toes” Sign pulls away the foundation from distal to proximal. If you don’t see, Tarsal Tunnel Syndrome Tailor’s Bunionette Prolonged Pronation The tibia twists abnormally on the femur, leading Tibialis Posterior Navicular Drop/Sag to knee strain and joint degeneration. you don’t treat. Neuropathy Adductovarus Toes The head of the femur is pulled from the pelvis, Achillies Tendonitis leading to hip symptoms. If you don’t treat, Flexor Stabilization Hammer Toes The pelvis drops, leading to excessive tilt, which the problems continue.” immediately places tremendous strain on the vertebrae of the lower and upper back. This leads to shoulder tilt, which the neck tries to compensate for, resulting in a twisting of the skull. Finally, the mandible is misaligned leading to excessive unilateral muscle contraction and TMJ disorders.
  • 7. “Simplicity is achieving maximum results with Internal Deformity = Internal Solution minimal effort.”
  • 8. The Solution - HyProCure The Results - HyProCured What is HyProCure? An extra-osseous, extra-articular, internal bone fixation device. “Simplicity is achieving maximum results with minimal effort.” HyProCure – made entirely of medical grade titanium, is simply pushed into the naturally occurring space between the ankle and heel bone, once the joints are properly realigned. The normal amount of motion is restored. HyProCure offers the best anatomic design and bio- mechanical function. Before After Before After
  • 9. When external measures are not enough and traditional reconstructive To learn more please visit surgery is too HyProCure.com aggressive, think...
  • 10. Indications: Potential Complications: Obliteration (partial/full) of the sinus tarsi Prolonged pain, edema, stiffness, discomfort Abnormal talar deviation on the calcaneus and walking difficulty Flexible and reducible deformity Migration/Displacement of the device Older than 3 years of age Need for revision/removal of the device Under/Overcorrection Contra-Indications: Synovitis/Bursitis Rigid non-reducible deformity Infection Less than 3 years of age Other risks associated with surgery Active local infection Very poor bone stock
  • 11. Will I feel the device in my foot? Frequenty Asked Questions: You should not be able to feel the device 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 over time. Will there be a visible scar? How do I know if I am a candidate for this procedure? The incision is rather small and located below the outer ankle bone. This part of the skin heals remarkably well. There must be a flexible deformity. If the hindfoot can be manually positioned back to its normal alignment Depending on your skin type, your scar should continue to fade and in some cases completely disappears. then this should work, however, an examination by a foot specialist is required. After the HyProCure procedure, will I need to be on antibiotics prior to dental treatment Are there any limitations, as far as sports go, after this procedure? or other future surgical procedures? Once the tissues surrounding the device are healed, there should be no limitation. The abnormal motion is Due to the size, position and location of the HyProCure device in the foot, there is no need to premedicate prior no longer present and normal motion will occur. Usually, there is a significant improvement in walking, to dental or other surgical procedures. running and related activities. Can I still get MRIs, CT scans, etc. with the device in my foot? What are the chances of getting an allergic reaction to this device? Yes, titanium is not reactive to these imaging modalities, unlike stainless steel, though there may be a “star-burst” Titanium is the choice material to be used in the body since it is the least reactive. effect surrounding the device. Does the device set off the metal detector at the airport? Will this device get rid of all of the pains in my body? HyProCure is made of titanium and should not set off the metal detector at the airport. No one can predict the outcome of any surgical procedure, but it is a fact that this solution should improve your body's alignment. As a result, reduction and relief of many pains caused by the foot imbalance will also be reduced Should I have this surgery even though I don't have any symptoms? or eliminated. However, it is possible that some of the joints and soft tissues in the body may have already suffered If a deformity is present, the sooner it is treated the less damage will occur. You don't want to wait for pain. irreversible wear and tear, and in those cases other treatments or procedures might be necessary. In either case, At that point, there may be irreversible damage. We don't wait until our car tires are worn to balance them. correcting the root of the problem is still essential to stopping any further damage and to allow for any additional therapies (if necessary) to be long lasting. Is there drilling or bone cutting involved in this procedure? The device is simply slid into the natural space inside the foot without any drilling or bone cutting involved. Will I still have to wear arch supports after the procedure? HyProCure is designed to maintain the natural space that already exists inside the foot, therefore no Arch supports have a hard time stabilizing the ankle bone on the heel bone and if that was the sole reason to wear invasive force is needed to insert it. The threads on the device allow the tissues to hold HyProCure in place. the arch supports you shouldn’t need them anymore. On the other hand, there maybe other associated foot deformities that may require the use of arch supports. If this procedure is performed on a child, does it have to be replaced later in life? Most likely not, it is intended to last for life. What causes this condition? It is most commonly caused by hereditary or genetic factors. Do I need this procedure even if I have a mild case? That depends. If you have symptoms and other forms of conservative therapy, including arch supports, Are there limitations to this procedure? haven't been able to provide you with relief, then this procedure may be helpful. Yes, every surgical procedure has its limitations. In severe cases of dislocation, other surgical procedures may be necessary to achieve optimal correction or possibly a combination of procedures.
  • 12. GraMedica 16137 Leone Drive Macomb, MI 48042 Toll-free: 888.566.6459 Phone: 586.677.9600 www.HyProCure.com ® Made in the USA © GraMedica 2011 HYP PT Cure / Rev. 05.15.11