The effect of extra-osseous talotarsal stabilization (EOTTS) to reduce medial knee compartment forces - An in vivo study.

Background: Excessive hindfoot pronation, talotarsal joint (TTJ) instability, has been attributed to an increase in medial knee compartment pathology. Advocacy for hindfoot realignment has been the subject of research. An internal solution for TTJ instability, extra-osseous talotarsal stabilization (EOTTS), exists but its effect on knee forces is unknown.

Inherent Strength of the osteo-WEDGE(™) Bone Plate Locking System for Arthrodesis of the First Metatarsocuneiform Joint: A Biomechanical Study.

First metatarsocuneiform joint arthrodesis with a locking bone plate and screw system has been effectively used to correct metatarsus primus varus and instability of the first ray. The goal of the present cadaveric biomechanical study was to quantify and compare the inherent strength of the first metatarsocuneiform joint and surrounding bones fixated with the osteo-WEDGE(™) bone plate locking system (OW) with that of intact specimens. Fourteen fresh-frozen adult human cadaveric foot specimens consisting of the first metatarsal and medial cuneiform bones with intact joint capsules and ligaments were used.

Congenital talotarsal joint displacement and pes planovalgus: evaluation, conservative management, and surgical management.

The diagnosis of and preferred treatment regimens for pediatric flatfoot, a complex and ambiguous deformity, continues to be debated. Incongruence of the talotarsal joint, whether flexible or rigid, is always present in pes planovalgus. However, it is important to note that talotarsal dislocation can occur without a flatfoot.

Surgical treatment of hyperpronation using an extraosseous talotarsal stabilization device: radiographic outcomes in 70 adult patients.

The purpose of this study was to determine radiographic correction achieved in adult patients treated with an extraosseous talotarsal stabilization (EOTTS) procedure. Patients diagnosed with flexible/reducible talotarsal joint dislocation (partial) underwent surgical correction with the HyProCure(®) EOTTS device. Preoperative and postoperative weightbearing radiographs taken in the anteroposterior (AP) and lateral views for a total 95 feet (in 70 patients) were analyzed to determine standardized radiographic angles, and to quantify the correction obtained after the EOTTS procedure.

Extraosseous talotarsal stabilization devices: a new classification system.

Displacement of the articular facets of talus on the tarsal mechanism, or partial talotarsal dislocation, is a condition seen in children, adult, and geriatric populations. A characteristic of this pathologic condition is a prolonged period of and excessive amount of pronation (hyperpronation) on weightbearing. The ill effects of this condition may lead to a multitude of other foot pathologies and to pathologies associated with the proximal lower extremity musculoskeletal structures.

Extraosseous talotarsal stabilization using HyProCure® in adults: a 5-year retrospective follow-up.

The purpose of this retrospective study was to determine long-term functional outcomes and device tolerance achieved in adult patients who chose to undergo an extraosseous talotarsal stabilization procedure HyProCure(®) for the treatment of flexible talotarsal joint deformity. Eighty-three adult patients participated in this study. Postoperative subjective assessment of device performance was evaluated using Maryland Foot Scores, which were collected at a mean follow-up period of 51 months.

Validation of the talar-second metatarsal angle as a standard measurement for radiographic evaluation.

Background: Radiographs provide valuable information for assessing osseous foot deformities and aid in accurate diagnosis. The radiographic angular measurements can be used to establish a relationship between the forefoot and the hindfoot that will present valuable information about normal versus pathologic alignment of the foot. The talar-first metatarsal (T1M) angle is frequently used as one of these angles in this capacity; however, there are limitations to the anteroposterior T1M angle.

Stabilization of joint forces of the subtalar complex via HyProCure sinus tarsi stent.

Background: The foot is the foundation of the body. The stability of the osseous hindfoot structure is crucial in bipedal locomotion. The subtalar joint is responsible for conversion of the rotatory forces of the lower extremities and dictates the movements of the midtarsal joints and the forefoot.

Evaluating plantar fascia strain in hyperpronating cadaveric feet following an extra-osseous talotarsal stabilization procedure.

Abnormal talotarsal joint mechanics leading to hyperpronation is implicated as one of the most common causes of plantar fasciopathy. In patients with hyperpronating feet, the plantar fascia experiences excessive tensile forces during static and dynamic weight-bearing activities because of excessive medial longitudinal arch depression. For the purposes of this study, we hypothesized that plantar fascia strain in hyperpronating cadaveric feet would decrease after intervention with an extra-osseous talotarsal stabilization (EOTTS) device.

Effect of extra-osseous talotarsal stabilization on posterior tibial tendon strain in hyperpronating feet.

Posterior tibial tendon dysfunction is considered one of the most common causes of progressive adult acquired flatfoot deformity. The etiology leading to the dysfunction of posterior tibial tendon remains controversial. The purpose of this study was to quantify strain on the posterior tibial tendon in cadaver feet exhibiting hyperpronation caused by flexible instability of the talotarsal joint complex.

Effect of extra-osseous talotarsal stabilization on posterior tibial nerve strain in hyperpronating feet: a cadaveric evaluation.

Excessive abnormal strain or tension on the posterior tibial nerve in feet exhibiting talotarsal instability has been considered one of the possible etiologic factors of tarsal tunnel syndrome. The suggested treatment options in such cases include stabilization of the talotarsal joint complex in a corrected position, which might help minimize the abnormal forces placed on the posterior tibial nerve due to over stretching. The primary goal of this study was to quantify strain on the posterior tibial nerve in feet exhibiting hyperpronation caused by talotarsal instability, before and after an extra-osseous talotarsal stabilization (EOTTS) procedure.

Radiographic evaluation of navicular position in the sagittal plane-correction following an extraosseous talotarsal stabilization procedure.

The navicular drop in the sagittal plane on weight-bearing is a valid indicator of foot pronation. Dislocation of the talus on the tarsal mechanism results in hyperpronation, which can lead to excessive navicular drop. The purpose of the present study was to radiographically determine the efficacy of HyProCure(®) in realigning the navicular bone in hyperpronating feet.

The effect of HyProCure(®) sinus tarsi stent on tarsal tunnel compartment pressures in hyperpronating feet.

Tarsal tunnel syndrome is characterized by increased pressure in the tarsal tunnel. In hyperpronation, there is excessive abnormal pronation resulting from partial displacement of the talus on the calcaneus. In this study, we hypothesized that hyperpronation caused by talotarsal instability will lead to increased pressure in the tarsal tunnel and porta pedis.