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Implantable Shock Absorber: Breakthrough or Hype?

Jared A Nowell1, David C Flanigan2

  • 1Department of Orthopaedic Surgery, The Ohio State University Wexner Medical Center, 2835 Fred Taylor Drive, Columbus, OH, 43202, USA.

Current Reviews in Musculoskeletal Medicine
|March 25, 2026
PubMed
Summary

Implantable shock absorbers (ISA) offer a surgical option for knee osteoarthritis, reducing pain and improving function. This technology provides a viable alternative to arthroplasty for select patients.

Keywords:
Implantable shock absorberKnee osteoarthritisKnee preservationMedial knee pain

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Musculoskeletal research

Background:

  • Osteoarthritis (OA) is a degenerative joint disease affecting millions.
  • Medial compartment knee osteoarthritis often requires surgical intervention.
  • Arthroplasty and osteotomy are common but invasive treatments.

Purpose of the Study:

  • To review the current understanding of implantable shock absorbers (ISA).
  • To discuss ISA's mechanism of action, patient usage, and outcomes.
  • To explore the future potential of ISA technology.

Main Methods:

  • Review of existing literature on implantable shock absorbers.
  • Analysis of biomechanical data and clinical trial results.
  • Comparison of ISA with other treatment modalities like HTO and arthroplasty.

Main Results:

  • ISA reduces peak medial compartment knee force by 32%.
  • Studies show ISA is superior to High Tibial Osteotomy (HTO), improving pain and function.
  • Five-year survivorship and freedom from conversion to arthroplasty is 85% with ISA.

Conclusions:

  • Implantable shock absorbers are a reasonable surgical option for medial compartment knee osteoarthritis.
  • ISA offers an alternative to arthroplasty for patients unsuitable for or unwilling to undergo major surgery.
  • ISA preserves native anatomy, avoiding osteotomy or arthroplasty disruption.