MACOMB, Michigan, May 14, 2019

A recently published medical study shows nearly 94% of patients who experience chronic heel pain (plantar fasciitis) also suffer from hindfoot instability—an orthopedic deformity where the ankle bone partially dislocates on the hindfoot bones.1 This is the missing link in the diagnosis and treatment of plantar fasciitis, and the primary reason standard treatment options are ineffective at providing long-term relief.

Plantar fasciitis is a painful condition where the fibers of the plantar fascia, a strong ligament-like structure that supports the arch of the foot, become partially ruptured. One of the most common causes of plantar fascia rupture is increased forces acting on the tissue while standing, and with every step taken. Typical treatments are focused on the reduction of the associated pain and/or measures to allow the healing of the tissue. However, little is done to address the underlying cause—the reduction of the forces causing the strain to the plantar fascia.

A common form of treatment is the use of arch supports or foot orthotics. These have shown to have a positive effect initially, but the scientific evidence shows no long term results. Furthermore, there is no scientific evidence to support that orthotics reduce the strain on the plantar fascia. This is because the partial dislocation of the ankle and heel bones is an internal deformity. Without surgical intervention, the ankle bone will continue to turn inward and forward, leading to further strain to the plantar fascia.

The most effective solution is extra-osseous talotarsal stabilization (EOTTS), which involves the insertion of a small titanium stent into a naturally occurring space located between the ankle and heel bones, called the sinus tarsi. EOTTS is a minimally invasive, soft tissue procedure that is scientifically proven to realign the hindfoot bones and still allow natural range of motion.
A previously published study showed a significant reduction in plantar fascia strain with the EOTTS treatment.
2 Furthermore, the titanium stent can be removed/reversed, unlike other surgical procedures used to realign and stabilize the hindfoot bones.

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About GraMedica

We are a global orthopedic company that specializes in the development of innovative foot and ankle solutions such as HyProCure®, Opti-Toe® and Osteo-wedge®. Our uniquely designed products provide surgeons with treatment options that create improved patient outcomes.

Together, with a dedicated group of renowned surgeons in over 70 countries, we have improved the quality of life for tens of thousands of patients. Our goal is to continue to educate, support and become an indispensable partner to foot and ankle surgeons, so we may continue changing the lives of patients world-wide, one step at a time.


1. Graham ME, Kolodziej L, Kimmel HM. The Frequency of Association between pathologic Subtalar Joint Alignment in Patients with Recalcitrant Plantar Fasciopathy–A Retrospective Radiographic Evaluation. Clin Res Foot Ankle. 2019, 7:2.

2. 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.

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