Flipbook

Licensed for use on publications wholly owned by 3D Issue version 7. Copyright (C) 2016 Trinity Innovations LTD. All rights reserved. This application is protected by copyright law and international treaties. Visit www.3dissue.com. Unauthorized use of this program or any portion of it, may result in severe civil and criminal penalties and will be prosecuted to the maximum extent possible under law.

GraMedica

00:00

Economic Impact of Misaligned Feet Misaligned Feet will affect your finances! AlignMyFeet.com I © GraMedica

Introduction Our feet have often been neglected and downplayed. Very little attention is given to one of the most used parts of our body, our feet. We brush our teeth 2 or 3 times a day, but barely look at our feet…that is, until your feet start hurting. Foot pain or pain that occurs to your knee, hip, and back will severely affect your quality of life. Actually, if you experience pain as a result of standing, walking, or running, you will stand, walk, or run less. That means your metabolism will drop and your health will suffer. Believe it or not, foot alignment has been proven to destroy the tissues within your feet, knees, hips and back. This ebook was written to open the eyes of those who have misaligned feet to both the problem and possible solution. Note: Please click on this icon to view a video demo Disclaimer: No part of this publication may be reproduced or retransmitted in any form or by any means, including, but not limited to, electronic, mechanical, photocopying, recording, or any information storage or retrieval system, without prior written permission of the publisher. Unauthorized copying may subject violators to criminal penalties, as well as liability for substantial monetary damages, costs and attorney’s fees. Neither the authors nor the publisher may be held liable for any misuse or misinterpretation of the information in this publication. All information provided is believed and intended to be reliable. All Rights Reserved Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 2

The negative effect of misaligned feet to your body. A misaligned foot will create a path of tissue destruction. A pathup the leg affecting the knee, hip, pelvis, and back. These excessive forces will continue to exert their damages to those parts of the body while standing, walking, or running. The more active you are with a misaligned foot, the sooner you’ll develop symptoms to the weakest link of your musculoskeletal chain. Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 3

Symptoms: its not if, its when! Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 4

< 18 years • • • • • • Growing pains/shin splints Lack of enthusiasm to stand/walk Want to be carried Clumsy gait No desire to exercise or play sports Excessive shoe wear • • • • Decreased activity level Weight gain Obesity High risk for juvenile diabetes 18 to 46 • • • • • • • Shin splints Plantar fasciitis/fasciopathy Mild/Moderate bunions/Hallux Limitus Nerve entrapment Knee pain Hip pain/Sciatica Back pain/herniated discs • • • • • • • • Decreased activity level Weight gain Obesity Developmental diabetes Foot surgery Knee surgery (arthroscopic) Chronic hip pain Chronic back pain > 46 The symptoms of misaligned feet appear as different problems. • • • • • • • • Restless leg syndrome Weakened plantar fascia Posterior tibial tendon dysfunction Severe bunions, Hallux Rigidus Plantar neuropathy Knee osteoarthritis Hip osteoarthritis Spinal stenosis • • • • • • • • Obesity Diabetes Hypertension Heart disease Failed Foot surgery Failed Knee surgery) Failed hip surgery Failed back surgery Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 5

The negative effect misaligned feet can have on your health! Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 6

Functional Symptoms Increased activity = PAIN!! Increased perception of pain Psychological Effects Physical Effects Activity avoidance Anxiety Depression Further deconditioning Progressive deconditioning Impoverished mood Fear Further activity avoidance Anger Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica Pain with decreasing activity 7

Obesity leads to all sorts of problems. Diabetes Sleep Apnea Heart Disease obesity Gerd (Acid Reflux) Cancer High Blood Pressure Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 8

Leading recommendation … Its easy…just get out and walk! Doesn’t take any special skills. Anyone can do it. Not so fast… It’s just not that easy. There’s a reason why this all started in the first place. Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 9

The negative effect misaligned feet can have on your finances. When you develop pain to your feet, knees, hips, and back. Sooner or later other medical issues will appear and you’ll have to start seeking professional medical care. There are insurance deductibles, co-pays, prescription and non-prescription medicines, arch supports, special shoes, injections, and even surgery. There are the associated surgical costs - hospital, anesthesia, and surgeon fees. Then there’s physical therapy. When is it going to end? Economic Impact of Misaligned Feet After all of that, do you know that the leading complication of treatment is? –Recurrence AlignMyFeet.com I © GraMedica 10

But wait there’s more… Knee surgery: Hip surgery: Back surgery: 4 million US citizens have had their knees joints replaced. In 2010, there were 310,800 hip replacement in patients over 45 years of age and older. More than 100 million Americans have back pain. Over half of the adults in the US diagnosed with knee osteoarthritis will undergo a total knee replacement. Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica Up to $300 billion a year is spent on treatment. 11

Cost of treating knee, hip, and back pain. $28.5 billion was paid to hospitals for knee replacements. Economic Impact of Misaligned Feet $13.7 billion was paid to hospitals to treated hip osteoarthritis. AlignMyFeet.com I © GraMedica Total health care cost to society was estimated to be as much as $635 billion in 2010. 12

Cost of treating… Obesity is the biggest driver of preventable chronic diseases in the USA. Estimated costs up to $210 billion a year. Treatment of high blood pressure is estimated at $42.9 billion dollars. There are 58.6 million people age 18 and older being treated. There are nearly 30 million Americans that have been diagnosed with diabetes. Another 86 million are considered to be pre- diabetic. Costs $322 billion a year to treat. Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 13

Maybe we need to fix those misaligned feet? Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 14

If you don’t know what’s wrong, how can you fix it? What causes the foot to become misaligned? Economic Impact of Misaligned Feet How can we realign, the misaligned foot? AlignMyFeet.com I © GraMedica 15

Anatomy 101 To understand why someone would or could develop a misaligned foot, you must understand the actual structures (bones, joints, ligaments, muscles and tendons) of the foot. There are 26 bones, 33 joints, and more than 100 soft tissue structures that form the foot machine. Don’t worry, we’re only going to focus on a few of the key structures. Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 16

The foundation joint of the body. The entire body rests on the ankle and heel bones. Their alignment and stability is what determines if the foot is stabile and aligned or unstable and misaligned. The ankle bone (talus) should be located on the top of the heel bone (calcaneus). Located between the two bones is a naturally occurring space called the sinus tarsi (tar-sigh). That sinus tarsi canal should always be in an open position as indicated by the arrow in the picture to the right. Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 17

Ankle bone displacement There is a common condition where the ankle partially dislocates on the heel bone. This is something that one either has, born with, or doesn’t have, will never develop. The ankle bone has displaced from its normal position and shifted forward and angles downward. This can be a flexible deformity, especially early in life, but eventually, it can become a fixed or rigid deformity, meaning the ankle bone cannot be placed back on the heel bone. Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 18

Why is ankle bone displacement bad? The only different between the “flat” foot and the “normal” foot is that the ankle bone is aligned on the heel bone in the normal foot, and is partially dislocated/displaced in the “flat” foot. When there is no weight on the foot, the ankle bone is where it should be, but after this patient stands, the weight of the body pushes the ankle bone from it’s normal alignment. This condition will never, fix itself. Furthermore, most of the population is walking around not even knowing they even have it. Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 19

The effect of ankle bone displacement on the ankle joint. Stable Ankle Bone Economic Impact of Misaligned Feet Displacing Ankle Bone AlignMyFeet.com I © GraMedica 20

A misaligned ankle bone is a deformity that should be realigned. Ankle bone instability is something that is seen in childhood. Unfortunately, most parents and children are told that it is nothing to be concerned about and that the child will just outgrow this condition. Again, a displaced ankle has never been proven to “fix” itself. It doesn’t get better with time, it gets worse. Not all ankle bone displacements will end up as severe as this one to the right, but most are going to lead to some form of ailment, are you willing to gamble with it? Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 21

What are the treatment options? Now that know what causes the foot to become misaligned. What can be done to fix it? There are many different opinions by various medical professionals as to the best form of treatment. It is very important to understand that each foot, and every patient, will have a unique set of circumstances. It is important that you seek guidance from a foot specialist. Only they can determine which options would make sense for your situation. Economic Impact of Misaligned Feet There are amazing foot specialists out there waiting to help you. AlignMyFeet.com I © GraMedica 22

The solution begins with realignment and stabilization of the ankle bone. A misaligned and displaced ankle bone leads to excessive strain on the mid- and forefoot. How can we turn this misaligned foot How can the ankle bone be realigned and stabilized? This has to be first question to be asked and answered. Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica into this aligned foot? 23

Is there a magic pill or shot? Pills, especially for pain, only mask the symptom and they do NOT fix the problem. The same is true with shots. Pills or shots only help to ease the pain. How is a pill or a shot going to work? Unfortunately, many patients are just given this option. Yes, it may give temporary relief, but it never solves the underlying root-cause of the problem… Bottom-line: Pills and/or shots do not address the underlying etiology: A displaced-misaligned ankle bone. Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 24

Foot orthosis-arch supports + The role of arch supports remains among one of the first lines of treatment. + How exactly is an arch support supposed to work? To support the arch? + That means that the arch support has to realign and stabilize the ankle bone, prevent the partial dislocation of the ankle bone. + Arch supports cannot realign and stabilize the ankle bone. There are no scientific or radiographic studies that show the ankle bone realignment with an arch support. Economic Impact of Misaligned Feet Bottom-line: Arch supports do not address the underlying etiology: AlignMyFeet.com I © GraMedica A displaced-misaligned ankle bone. 25

Here’s the proof that an arch support cannot realign and stabilize the ankle bone! These are weightbearing fluoroscopic images with an orthotic, showing that the ankle bone displacing from its normal position. Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 26

So how can we realign and stabilize the ankle bone? Conservative, external measures cannot and have not, been proven to realign and stabilize the ankle bone. There have been many aggressive internal surgical procedures that have been tried. Unfortunately, the cure can be worse than the disease with these options. These procedures are associated with a long recovery, many potential risks and complications. Most patients will have to be brought back to the operation room to remove painful pins or screws. There has to be a better option! Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 27

The good news – there’s another treatment option. There is a minimally invasive procedure, called extra-osseous talotarsal stabilization (EOTTS), where a small titanium stent is inserted into the sinus tarsi space. This stent maintains the normal hindfoot alignment, while allowing the natural joint motion. Instantly, the ankle bone is realigned and stabilized. This instantly reduces the rearfoot acting on the forefoot. Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica Before After 28

EOTTS-HyProCure Procedure ® + The HyProCure stent has proven positive results, 94% success. + “Arthroereisis” implants, on the other hand, have proven failures, up to a 100% failure rate. This EOTTS-HyProCure procedure takes about 15 minutes, on average, to perform. The results are instant. + The success of the HyProCure stent is what make it the treatment of choice by leading foot surgeons in nearly 60 countries. + HyProCure fixes the underlying root- cause etiology. It works! + It is scientifically proven to reduce the excessive forces acting on the mid- and forefoot. Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 29

The HyProCure Advantages ® + Offers a long term solution for your misaligned feet, unlike the other common solutions that are often tried by those who suffer from foot pain. + This stent has been FDA cleared since 2004 and CE marked. In fact, it is used by leading foot and ankle surgeons in 60 countries. + The stent is meant to be permanent, yet it is reversible. + HyProCure is routinely used in both children and adults, to address other issues caused by ankle bone displacement. + Most patients experience minimal pain and are allowed to bear weight on their feet the same day. + Once fully recovered, patients are able to run, jump and participate in physical activities, allowing them to finally experience life pain free again*. + Unlike arch supports, HyProCure functions with or without shoes. *Individual result may vary. Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 30

EOTTS-HyProCure Effect on ankle bone alignment & stability. Instantly, the ankle bone is realigned and stabilized with the HyProCure sinus tarsi stent. Immediately, the excessive forces that were placed on the inner arch are decreased. It is backed by extensive scientific research. Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 31

Urgency to fix ankle bone displacement sooner, than later! This foot will… Economic Impact of Misaligned Feet Eventually transform into this foot. AlignMyFeet.com I © GraMedica 32

HyProCure in action… Ankle bone displacement - before Economic Impact of Misaligned Feet Ankle alignment and stability – after HyProCure was inserted into the sinus tarsi. AlignMyFeet.com I © GraMedica 33

HyProCure in action… Ankle displacement - before Economic Impact of Misaligned Feet Ankle alignment and stability – after HyProCure was inserted into the sinus tarsi. AlignMyFeet.com I © GraMedica 34

Complete treatment Depending on the severity of your condition, it is possible that you will be required to use an arch support to help other parts of your foot, or that you will require other surgical procedures to realign, repair, or stabilize other “broken” parts of the foot. We hope that this ebook has brought a better awareness to the reader on the condition, why it is not a “good” thing, why it developed in the first place, and what can be done to fix it. Good luck and keep walking. The sooner you seek treatment, the more treatment options you will have. Do your body a favor and schedule an appointment today with a qualified foot specialist to see what options make the most sense for you. Economic Impact of Misaligned Feet AlignMyFeet.com I © GraMedica 36

References Frilander H, Viikari-Juntura E, Heliovaara M, Mutanen P, Mattila VM, Solovieva S. Obesity in early adulthood predicts knee pain and walking difficulties amount men: a life course study. Eur J Pain. 20(8): 1278-87, 2016. Katz, JN, Smith SR, Collins JE, Solomon DH, et. al. Cost-effectiveness of nonsteroidal anti-inflammatory drugs and opioids in the treatment of knee osteoarthritis in older patients with multiple comorbidities. Osteoarthritis Cartilage. 24(3):409-18, 2016. Konopka JF, Gomoll AH, Thornhill TS, Katz JN, Losina E. The cost-effectiveness of surgical treatment of medial unicompartmental knee osteoarthritis in younger patients: a computer model-based evaluation. J Bone Joint Surg AM. 97(10):807-17, 2015. Kallala RF, Vanhegan IS, Ibrahim MS, Sarmah S, Haddad FS. Financial analysis of revision knee surgery based on NHS tariffs and hospitals costs: does it pay to provide a revision service? Bone Joint J. 97-B(2):197-201, 2015. Waimann CA, Fernandez-Mazarambroz RJ, Cantor SB, Lopez-Olivo MA, et. al. Cost-effectiveness of total knee replacement: a prospective cohort study. Arthritis Care Res (Hoboken). 66(4):592-9, 2014. Ruiz D Jr, Koenig L, Dall TM, Gallo P, Narzikul A, Parvizi J, Tongue J. The direct and indirect costs to society for treatment of end-stage knee osteoarthritis. J Bone Joint Surg AM. 95(16): 1473-80, 2013. Weinstein AM, Rome BN, Reichmann WM, Collins JE, et. al. Estimating the burden of total knee replacement in the United States. J Bone Joint Surg Am. 95(5):385-92, 2013. Hermans J, Koopmanschap MA, Bierma-Zeinstra SM, van Linge JH, et. al. Productivity costs and medical costs among working patients with knee osteoarthritis. Arthritis Care (Hoboken). 64(6):853-61, 2012. Andronis L, Kinghorn P, Qiao S, Whitehurst DG, Durrell S, McLeod H. Cost-Effectiveness of Non-Invasive and Non- Pharmacological Interventions for Low Back Pain: a Systematic Literature Review. Appl Health Econ Health Policy. 2016 (ahead of print). Frilander H, Solovieva S, Mutanen P, Pihlajamaki H, Heiovaara M, Viikari-Juntura E. Role of overweight and obesity in low back disorders among men: a longitudinal study with a life course approach. BMJ Open. 5(8):e007805, 2015. Patient’s Guide to Adult Acquired Flat Foot AlignMyFeet.com I © GraMedica 38

References Global Burden of Disease Study 2013. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 386(9995):743-800, 2015. Lazkani A, Delespierre T, Bauduceau B, et. al. Healthcare costs associated with elderly chronic pain patients in primary care. Eur J Clin Pharrmacol. 71(8):939-47, 2015. Murphy L, Helmick CG.The impact of osteoarthritis in the United States: a population-health perspective. Am J Nurs. 2012;112(3 Suppl 1):S13-9. Maetzel A, Li LC, Pencharz J, Tomlinson F Bombardier C. The economic burden associated with osteoarthritis, rheumatoid arthritis, and hypertension: a comparative study. Ann Rheum Dis. 2004;63(4):395-401. Leyland KM, Hart DJ, Javaid MK, Judge A, et al. The natural history of radiographic knee osteoarthritis: a fourteen- year population-based cohort study. Arthritis Rheum. 64(7):2243-51. 2012 Halaweh H, Willen C, Drimby_Ekman A, Svantesson U. Physical Activity and Health-Related Quality of Life Among Community Dwelling Elderly. J Clin Med Res. 7(11):845-52, 2015. Kist C, Gier A, Tucker J, Barbieri TF, johnson-Branch S, Moore L, Picard S, Lukasiewicz G, Coleman N. Physical activity in clinical pediatric weight management programs: Current Practices and Recommendations. Clinc Pediatr (Phila). 55913):1219-1229, 2016. Kist C, Gier A, Tucker J, Barbieri TF, johnson-Branch S, Moore L, Picard S, Lukasiewicz G, Coleman N. Physical activity in clinical pediatric weight management programs: Current Practices and Recommendations. Clinc Pediatr (Phila). 55913):1219-1229, 2016. Riddiford-harland DL, Steele JR, Cliff DP, Okley AD, Morgan PJ, Jones RA, Baur LA. . Lower activity levels are related to higher plantar pressures in overweight children. Med Sci Sports Exerc. 47(2):357-62, 2015. Shultz SP, D’Hondt E, Fink PW, Lenoir M, Hills AP. The effects of pediatric obesity on dynamic joint malalignment during gait. Clin Biomech (Bristol, Avon) 29(7):835-8, 2014. Smith SM, Sumar B, Dixon KA. Musculoskeletal pain in overweight and obese children. Int J Obes (Lond). 38(1):11-5, 2014. Patient’s Guide to Adult Acquired Flat Foot AlignMyFeet.com I © GraMedica 39

References Fuhrmann RA, Trommer T, Venbrocks RA. The acquired buckling-flatfoot. A foot deformity due to obesity? Orthopade. 34(7):682-9, 2005. Shultz SP, Sitler MR, Tierney RT, Hillstrom JH, Song J. Consequences of pediatric obesity on the foot and ankle complex. J Am Podiatr Med Assoc. 102(1):5-12, 2012. Resende RA, Deluzio KJ, Kirkwood RN, Hassan EA, Fonseca ST. Increased unilateral foot pronation affects lower limbs and pelvic biomechanics during walking. Gait Posture. 41(2):395-401, 2015. Khamis S, Dar G, Peretz C, Yizhar Z. The relationship between foot and pelvic alignment while standing. J Hum Kinet. 46:85-97, 2015. Farokhmanesh K, Shirzadian T, Mahboubi M, Shahri MN. Effect of foot hyperpronation on lumbar lordosis and thoracic kyphosis in standing position using 3-dimensional untrasound-based motion analysis system. Glob J Health Sci. 6(5):254-60, 2014. Kendall JC, Bird AR, Azari MF. Foot posture, leg length discrepancy and low back pain – their relationship and clinical management using foot orthoses- an overview. Foot (Edinb). 24(2):75-80, 2014. Khamis S, Yizhar Z. Effect of feet hyperpronation on pelvic alignment in a standing position. Gait Posture. 25(1):127- 34, 2007. Menz HB, Dufour AB, Riskowski JL, Hillstron HJ, Hannan MT. Foot posture, foot function and low back pain: the Framingham Foot Study. Rheumatology (Oxford). 52(12):2275-82, 2013. Cibulka MT. Low back pain and its relation to the hip and foot. J Orthop Sports Phys Ther. 29910):595-601, 1999. Parker N, Greenhalgh A, Chockalingam N. Dangerfield PH. Positional relationship between leg rotation and lumbar spine during quiet standing. Stud Health Technol Inform. 140:231-9, 2008. Pinto RZ, Souza TR, Trede RG, Kirkwood RN, Figueiredo EM, Fonseca ST. Bilateral and unilateral increases in calcaneal eversion affect pelvic alignment in standing position. Man Ther. 13(6):513-9, 2008. Knutson GA. Incidence of foot rotation, pelvic crest unleveling, and supine leg length alignment asymmetry and their relationship to self-reported back pain. J Manipulative Physiol Ther. 25(2):110E, 2001. Patient’s Guide to Adult Acquired Flat Foot AlignMyFeet.com I © GraMedica 40

References Duval K, Lam T, Sanderson D. The Mechanical relationship between the rearfoot, pelvis and low-back. Gait Posture. 32(4):637-40, 2010. Levinger P, Gilleard W. Tibial and rearfoot motion and ground reaction forces in subjects with patellofemoral pain syndrome during walking. Gait Posture. 25(1):2-8, 2007. Olerud C, Berg P. The variation of the Q angle with different positions of the foot. Clin Orthop relat Res. 191:162-5, 1984. Hertel J, Dorman JH, Braham RA. Lower extremity malalignments and anterior cruciate ligament injury history. J Sports Sci Med. 3(4):220-5, 2004. Fibel KH, Hillstrom HJ, Halpern BC. Sate-of-the-art management of knee osteoarthritis. World J Clin Cases. 392):89- 101, 2015. Tiberio D. Relationship between foot pronation and rotation of the tibia and femur during walking. Foot Ankle Int. 21(12):1057-60, 2000. Reischi SF, Powers CM, Rao S, Perry J. Relationship between foot pronation and rotation of the tibia and femur during walking. Foot Ankle Int. 20(8):513-20, 1999. Levinger P, Menz HB, Morrow AD, Bartlett JR, Feller JA, Bergman NR. Relationship between foot function and medial knee joint loading in people with medial compartment knee osteoarthritis. J Foot Ankle Res. 6(1):33, 2013. Levinger P, Menz HB, Fotoohabadi MR, Feller JA, Bartlett RJ, Bergman NR. Foot posture in people with medial compartment knee osteoarthritis. J Foot Ankle Res. 3:29, 2010. Barton CJ, Bonanno D, Levinger P, Menz HB. Foot and ankle characteristics in patellofemoral pain syndrome: a case control and reliability study. J Orthop Sports Phys Ther. 40(5):286-96, 2010. Tweed JL, Campbell JA, Avil SJ. Biomechanical risk factors in the development of medial tibial stress syndrome in distance runners. J Am Podiatr Med Assoc. 98(6):436-44, 2008. Patient’s Guide to Adult Acquired Flat Foot AlignMyFeet.com I © GraMedica 41

HyProCure Sinus Tarsi Stent References Xu Y, Li SC, Xu SY. Calcaneal Z Lengthening Osteotomy Combined with Subtalar Arthroereisis for Severe Adolescent Flexible Flatfoot Reconstruction. Foot Ankle Int. 37(11):1225-31, 2016. Steber S, Kolodziej L. Analysis of Radiographic Outcomes Comparing Foot Orthosis to Extra- Osseous Talotarsal Stabilization in the Treatment of Recurrent TaloTarsal Joint Dislocation. J Min Inv Orthop. 1;1-11, 2015. Graham, ME. Congenital Talotarsal Joint Displacement and Pes Planovalgus. Clin Podiatr Med Surg. 30:567-81, 2013. Bresnahan PJ, Chariton JT, Vedpathak A. Extra-Osseous TaloTarsal Stabilization using HyProCure®: Preliminary Clinical Outcomes of a Prospective Case Series. J Foot Ankle Surg. 52(2): 195-202 2013. Fitzgerald RH, Vedpathak A. Plantar Pressure Distribution in a Hyperpronated Foot Before and After Intervention with an Extra-Osseous Talotarsal Stabilization Device – A Retrospective Study. J Foot Ankle Surg. 52(4):432-43, 2013. Navi B, Theivendran K, Prem H. Computed Tomography Review of Tarsal Canal Anatomy with Reference To the Fitting of Sinus Tarsi Implants in the Tarsal Canal. J Foot Ankle Surg. 52(6): 714- 716, 2013. Graham ME, Jawrani, NT. Extra-Osseous Stabilization Devices: A New Classification System. J Foot Ankle Surg. 51(5):613-9, 2012. Graham ME, Jawrani, NT, Chikka A. Extra-Osseous TaloTarsal Stabilization using HyProCure® in Adults: A 5-Year Retrospective Follow-Up. J Foot Ankle Surg, 51(1): 23-29, 2012. Graham ME, Jawrani NT, Chikka A, Rogers RJ. Surgical Treatment of Hyperpronation Using an Extra-Osseous TaloTarsal Stabilization Device: Radiographic Outcomes in Adult Patients. J Foot Ankle Surg. 51 (5): 548-55, 2012. Patient’s Guide to Adult Acquired Flat Foot AlignMyFeet.com I © GraMedica 42

HyProCure Sinus Tarsi Stent References Graham ME, Jawrani NT, Goel VK. Evaluating plantar fascia strain in hyperpronating cadaveric feet following an extra-osseous talotarsal stabilization procedure. J Foot Ankle Surg. 50(6):682-6, 2011. Graham ME, Jawrani NT, Chikka A. Radiographic Evaluation of Navicular Position in the Sagittal Plane – Correction Following an Extra-Osseous TaloTarsal Stabilization Procedure. J Foot Ankle Surg, 50(5):551-7, 2011. Graham ME, Jawrani, NT, Goel VK. Effect of Extra-Osseous TaloTarsal Stabilization on Posterior Tibial Tendon Strain in Hyperpronating Feet. J Foot Ankle Surg. 50(6): 676-81, 2011. Graham ME, Parikh R, Goel V, Mhatre D, Matyas A. Stabilization of joint forces of the subtalar complex via HyProCure sinus tarsi stent. J Am Podiatr Med Asso. 101(5):390-9, 2011. Graham ME. Talotarsal Joint Displacement – Diagnosis and Stabilization Options. Foot and Ankle Quarterly, Volume 23, Issue 4, Pages 165-179, winter 2012. Graham ME, Jawrani, NT, Goel VK. Evaluating Plantar Fascia Strain in Hyperpronating Cadaveric Feet Following an Extra-Osseous TaloTarsal Stabilization Procedure. J Foot Ankle Surg. 50(6): 682-86, 2011. Graham ME. Jawrani NT, Goel VK. Effect of extra-osseous talotarsal stabilization on posterior tibial nerve strain in hyperpronating feet: a cadaveric evaluation. J Foot Ankle Surg. 50(6):672-5, 2011. Graham ME, Jawrani, NT, Goel VK. The Effect of HyProCure® on Tarsal Tunnel Compartment Pressures in Hyperpronating Feet. J Foot Ankle Surg. 50(1):44-9, 2011. Patient’s Guide to Adult Acquired Flat Foot AlignMyFeet.com I © GraMedica 43

A body in motion seeks to stay in motion. A body at rest seeks more rest. Keep your body in motion. Find your foot alignment specialist at AlignMyFeet .com www. Look for Us on Social Media 16137 Leone Drive, Macomb, MI 48042 USA © GraMedica 2017 I Rev HYPPGAAFF1216 I All Rights Reserved 44