{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:15:23Z","timestamp":1791821723524,"version":"4.3.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["CARTILAGE"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Subchondral insufficiency fracture of the knee (SIFK) is associated with high rates of osteoarthritis (OA) and arthroplasty. The implantable shock absorber (ISA) is an extra-capsular implant that unloads the medial knee compartment. This study compared the 2-year freedom from arthroplasty rates in subjects with medial knee OA and SIFK when treated with an ISA versus a matched cohort of patients treated non-surgically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This retrospective case-control study compared 2-year conversion rates to arthroplasty in SIFK score-, age-, and body mass index (BMI)\u2013matched control subjects without prior surgical history with ISA-implanted subjects from an ongoing prospective study. Baseline and final radiographs, and MRIs were reviewed for evaluation of meniscus or ligament injuries, insufficiency fractures, and subchondral edema. Kaplan-Meier analysis assessed survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty-two patients (21 Control: 21 ISA), mean age = 52.3 \u00b1 8.7 years, BMI = 29.5 \u00b1 3.9 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      , 40% female were evaluated. Both ISA and Control arms had the same numbers of low (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 4), medium (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 11), and high-risk (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 6) SIFK scores. One- and 2-year freedom-from-arthroplasty rates were both 100% for ISA subjects, and 76% and 55%, respectively, for Controls (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.001 for cross-group comparison). Control knees with low, medium, and high-risk SIFK scores had respective 1- and 2-year survival rates of 100% and 100%, 90% and 68% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.07 vs. ISA), and 33% and 0% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002 vs. ISA).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ISA intervention was strongly associated with avoidance of arthroplasty at a minimum 2 years, especially in patients with high-risk SIFK scores. SIFK severity scoring predicted relative risk of conversion to arthroplasty through at least 2 years in non-surgically treated subjects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19476035231154513","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T03:54:56Z","timestamp":1678334096000},"page":"164-171","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["Improved 2-Year Freedom from Arthroplasty in Patients with High-Risk SIFK Scores and Medial Knee Osteoarthritis Treated with an Implantable Shock Absorber versus Non-Operative Care"],"prefix":"10.1177","volume":"14","author":[{"given":"Ayoosh","family":"Pareek","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad W.","family":"Parkes","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas H.","family":"Gomoll","sequence":"additional","affiliation":[{"name":"Hospital for Special Surgery, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3248-8007","authenticated-orcid":false,"given":"Aaron J.","family":"Krych","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery and Sports Medicine, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,3,9]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3978\/j.issn.2305-5839.2014.11.13."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-002-0285-z."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200006000-00013."},{"key":"e_1_3_2_5_2","article-title":"The role of meniscal tears in spontaneous osteonecrosis of the knee: a systematic review of suspected etiology and a call to revisit nomenclature","volume":"42","author":"Hussain ZB","year":"2017","unstructured":"Hussain ZB, Chahla J, Mandelbaum BR, Gomoll AH, LaPrade RF. The role of meniscal tears in spontaneous osteonecrosis of the knee: a systematic review of suspected etiology and a call to revisit nomenclature. 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Conservative treatment of knee osteoarthritis. 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