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HyProCure Key in Treatment and Prevention of Foot and Ankle Neuropathy

  • Published: 2010-11-26 (Revised/Updated 2015-05-25) : Author: GraMedica
  • Synopsis: Minimally invasive foot implant offers new treatment option for tarsal tunnel syndrome.

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HyProCure is the Key in the Treatment and Prevention of Foot and Ankle Neuropathy - Minimally invasive foot implant offers new treatment option for tarsal tunnel syndrome.

Dr. Michael E. Graham, podiatric surgeon and inventor of the HyProCure talotarsal stabilization device, presented his findings on "Dynamic Effects of Hyper-pronation on Tarsal Tunnel Pressures and Posterior Tibial Nerve Strain and the Use of HyProCure" to the annual symposium of the Association of Extremity Nerve Surgeons (AENS) in Fort Worth, Texas recently.

His presentation was based on anatomic and bio-mechanic investigations he conducted at the University of Toledo's Engineering Center for Orthopaedic Research Excellence (E-CORE), Departments of Bioengineering and Orthopaedic Surgery within the Colleges of Engineering and Medicine.

The study was designed to measure both the pressures within the tarsal tunnel (the foot's version of the carpal tunnel) that increase during the walking cycle and while standing, and that can lead to pathologic compression of the main nerves serving the bottom of the foot to the tips of the toes. This compression not only crushes and destroys the nerve fibers within the tarsal tunnel it also leads to a decreased blood flow within the nerve. Ultimately this leads first to a variety of symptoms to the foot including: cold feeling to the forefoot, numbness/tingling in the toes, feeling like the sock is wadded up under the ball of the foot, or the sensation of walking on a stone. Eventually, the condition leads to a loss of feeling to the bottom of the foot and can commonly be associated with periods of severe pain.

This increased pressure leads to peripheral nerve compression syndrome of the foot, or Tarsal Tunnel Syndrome. Many times this condition is treated with rest, medications, and external modalities, but for many individuals, conservative treatment is not enough. However, with every step taken and every second of standing, more damage is occurring to these nerves and, eventually, tarsal tunnel decompression surgery is performed. As with any surgical procedure, there are risks and potential complications such as wound dehiscence, period of immobilization following the procedure, and possibility of re-occurrence. This added to the somewhat poor outcomes.

Graham noticed a direct correlation between a very common condition of partial displacement of the ankle bone (talus) on the hind-foot bones (tarsal bones), in addition to tarsal tunnel syndrome. He inserted the HyProCure device, a small titanium implant, into the sinus tarsi for a select number of patients suffering with this condition and found they indeed got better using just HyProCure and without receiving the tarsal tunnel surgery which has formed the basis for his research. His cadaveric research showed that there was a significant reduction in the pressures within the tarsal tunnel and porta pedis, a second tunnel where the nerves dive deep into the foot..

"It is truly amazing. We know from medical literature that excessive hind-foot motion is responsible for this, but we never really eliminated the underlying etiology," said Graham. "I tried custom-molded arch supports (orthotics), but for many patients it just led to more pain. The excessive hind-foot motion is due to the partial displacement of the talus on the tarsal bones and is an internal deformity, and therefore needs internal correction."

The HyProCure talotarsal stabilization device has been used by foot surgeons since 2004. "This represents a major paradigm shift in the treatment of this rather common condition. The problem with external devices such as splints, braces, and orthotics is that they just cannot stabilize the ankle bone on the hind-foot bones when compared to the internal stabilization that HyProCure provides," explained Graham.

The results of this study have been submitted to the Journal of Foot and Ankle Surgery and are slated to be published in the January/February 2011 issue.

The AENS was founded as a society to promote the collaborative study and development of medical research regarding the treatment of extremity nerve disease. For more information about the AENS, please visit

If you are suffering from foot, ankle, leg, knee and hip pain, you may be experiencing the effects of talotarsal dislocation syndrome. Please visit for more information about the symptoms and solutions. Podiatrists and other surgeons are invited to learn more about the HyProCure implant and procedure at, where they can also train online or find a live surgical training seminar in their area.

About HyProCure HyProCure is an internal talotarsal stabilization device that is placed inside the foot via a minimally invasive out-patient procedure. It instantly stabilizes the ankle bone on the hind-foot bones. HyProCure represents a real solution for talotarsal dislocation syndrome and excessive foot pronation.

About GraMedica GraMedica, headquartered in Macomb Township, Michigan, was founded in 2003. It directly oversees the research, production, physician training, public awareness/education and worldwide support - Website:


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