Many of you may have heard of HyProCure (hyperpronation cure) and wondered what it is. The HyProCure website does a very good job of explaining in detail, both descriptively and via graphics and illustrations.
In very basic terms during excess pronation the talus glides excessively across the calcaneus at the subtalar joint, this, in turn, unlocks the rest of the foot and can lead to the plethora of conditions we treat every day. The HyProCure device is a titanium spacer that sits in the sinus tarsi, not actually inside the joint and controls how much these bones move across each other. The device comes in various sizes and is fitted according to the amount of control required. The aim is to return the foot to a neutral position, leading to normal function, it does not “fix” or fuse anything.
The vast majority of time, functional orthoses and various physical therapies can control the excess pronation and symptoms dissipate. In situations where orthoses and other modalities have failed and symptoms persist, HyProCure is a great option. It functions exceptionally well, does not lead to damage to the surrounding structures and in the vast majority of times it is never noticed and is tolerated well.
The image is from a patient I had seen multiple times over a five-year period. She had persistent tibialis posterior symptoms and everything had failed. She returned to me finally in a CAM boot and had seen another surgeon who had offered complex flat foot reconstruction. Her foot was still flexible (which is essential for HyProCure) and hence was a great candidate for HyProCure. She finally decided she wanted to move to surgery and the spacer was inserted through a 1cm incision.
Recovery was very quick and she has had resolution of her symptoms and is over the moon. This link takes you to a great video (on Vimeo) showing a before and after paediatric patient.
If you have any specific questions or would like to discuss similar cases, feel free to contact me.
Also read:
Adult-acquired flat foot (PTTD)
Biomechanics of a pathology (bunions and pes planus)
Post-operative pes planus/flat feet/excess pronation
Pes planus
Accessory navicular with pes planus
(This content is intended for healthcare professionals only)