Suffer from flat feet?

If you do, there’s a good chance that there is discomfort, tiredness and decreased mobility that go hand in hand with it. If arch support insoles and stretching aren’t doing the trick, then sufferers are forced to look for more permanent solutions. But whether it is the cost, the recovery time or the general process, surgery can be daunting.

HyProCure surgery for flat feet is one of the most practical and least invasive options on the market.

Understanding Flat Feet and When HyProCure Surgery for Flat Feet Is Considered

Understanding what pes planus (flat feet) really means is critical to recognizing the extent of the potential impact. When the arch drops (partially or entirely), you have flat feet and the whole bottom of the foot (sole) is on the ground. Seems straightforward, but the consequences can become wide-reaching with implications for ankles, knees, hips and low back.

What Are Flat Feet and Why They Matter

There are two types: flexible flat feet and rigid flat feet. Flexible flat feet are where the arch appears when the foot is elevated but collapses when in contact with the body weight. While the arch in rigid flat feet does not change.

Flexible flat feet are much more common and generally what HyProCure is used for. The collapse of the arch not only affects the symmetry of the foot but causes the foot to underpronate meaning it turns inward when walking. This effects the entire body’s alignment and a number of symptoms are experienced including heel pain, shin splints, bunions and chronic pain in the lower limbs.

When Conservative Treatments Aren’t Enough

The majority of podiatrists and orthopedic physicians will initiate a non-surgical approach to this. Custom orthotics, physical therapy aimed at strengthening the posterior tibial tendon, footwear and anti-inflammatory agents are some initial options. For some of these people, the symptoms and pathology can be well controlled with these approaches.

When a patient who has been on a consistent treatment plan for 6-12 months still has not been able to obtain sufficient relief, surgery has become a viable option to explore. HyProCure is typically discussed now – especially for patients who have a flexible deformity and would like to avoid the more invasive reconstructive surgery.

What Is HyProCure Surgery for Flat Feet?

HyProCure is a small titanium stent that is implanted into the sinus tarsi – a natural channel in the space between the talus and the calcaneus. The implant is stabilizing the subtalar joint in the healthy position avoiding the excessive valgus collapse seen with flatfoot deformity. It is not a fusion procedure and joint movement is preserved.

How the HyProCure Implant Works in the Foot

The titanium stent is simply a spacer. The stent, when positioned in the sinus tarsi, reduces the amount of medial translation of the talus over the calcaneus, resulting in increased arch height and realignment of the ankle, knee, and hip. Since no bones are fused in the procedure, you retain good joint motion (traditionally we have lost motion in flatfoot reconstruction).

The implant is approved by the FDA for use in adults and children.

Who Is a Good Candidate for HyProCure Surgery?

Ideal candidates are those with symptomatic flexible flatfoot deformity who have failed conservative management. The operation has been performed on children as young as three, but the majority are done in adolescents and adults. Surgeons generally measure alignment radiographically in weight bearing X-rays, and utilize gait analysis, including measurement of the sinus tarsi canal, to determine whether the canal is a suitable size for the stent.

Patients with rigid flatfoot deformity, severe subtalar arthritis or certain osseous deformities may not be candidates for this operation.

The HyProCure Surgical Procedure Step by Step

If one is aware of the circumstances surrounding, during and immediately after the operation, it can aid greatly in alleviating some of the stress. The operation itself is not of prolonged duration compared with conventional reconstructive procedures, and is usually undertaken as a day case.

Before Surgery: Evaluation and Preparation

Preoperative assessment is normally weight bearing films, sometimes a CT scan and detailed clinical examination of gait and joint flexibility. The surgeon needs to ensure that the deformity is flexible and that the sinus tarsi is capacious enough for the implant. Standard preoperative instructions are given – no eating/drinking before anesthesia, stop certain drugs like blood thinners and have transit arranged for the end of the operation.

Some surgeons also request a pain assessment for later comparison.

During Surgery: What Happens in the Operating Room

The operation generally lasts 20-30 minutes per foot. A tiny incision-most likely less than an inch long-is made over the sinus tarsi. The stent is introduced and positioned through fluoroscopy and the correct placement is validated.

Most operations will be performed with local anesthesia and sedation, but general anesthesia may be used as well- usually for younger patients. With such a small incision, there is little scarring and less risk of traumatizing tissue as compared to most more invasive flatfoot procedures.

Recovery, Results, and Long-Term Outcomes

HyProCure patients recover more quickly than an open flatfoot reconstruction, but recovery does take patience and all patients should be prepared for a slow healing process. A majority of the HyProCure patients are partial weight bearing in a surgical boot within a few days.

Recovery Timeline and Activity Restrictions

Full weight bearing Usually occurs in one to two weeks but varies according to patients and surgeon 13. Patients are usually placed in supportive footwear around the 4 week period 13. Returning to non-high impact activity occurs within a range of 6–12 weeks, with high impact sports demanding between 3–6 months 13.

Follow up visits at regular intervals allow the surgeon to track the progress of implant positioning and overall alignment using imaginery 13.

Long-Term Benefits, Success Rates, and Implant Longevity

Published series have reported 85 to 95 percent satisfaction rate when used in well-selected patients. Designed to be permanent, removal of the implant if there is persistent pain can be done though removal rate in the various series are around 5 to 10 percent. Long term benefits include reduction of pain, gait mechanics and the mechanical load to the associated joints.

Several patients also report the need for less orthotics.

Risks, Costs, and Questions to Ask Your Surgeon

No surgical procedure is risk-free, and unfortunately HyProCure is no different. I think you will find being informed on the procedure is truly important.

Possible Complications and When HyProCure May Not Be Ideal

The most frequently encountered complication is discomfort or pressure sensation in the sinus tarsi, which may lead to removal of the implant. Other complications include migration of the stent, infection, and under-correction. Patients with rigid deformity, severe heel valgus, or degenerative arthritis fare better with a calcaneal osteotomy or subtalar fusion.

Cost, Insurance Considerations, and Choosing the Right Specialist

The surgery itself on a single foot could cost anywere between $3,000 and $7,000 without insurance, depending upon the facility and surgeon. Insurance coverage is very variable, so check ahead of time. Some insurance carriers regard the procedure as “experimental” and won’t cover it, so check beforehand.

Find a surgeon with documented experience in doing HyProCure– not just general foot surgery. How many cases does he do personally, what is the complications rate, how many revisions?

A doctor who can answer this openly would be preferable to one who cannot.