{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:42:10Z","timestamp":1787755330834,"version":"build-2784847793"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Moximed Inc."}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The implantable shock absorber (ISA) addresses patients within the knee osteoarthritis treatment gap between failure of nonsurgical care and arthroplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This follow-up of a prospective, open-label, comparative cohort study reports effectiveness and safety outcomes at 5 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Eighty-one participants received the ISA. Participants had statistically significant improvement in Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain (mean 43.4 point improvement, p &lt; 0.0001) and function (mean 42.1 point improvement, p &lt; 0.0001) versus baseline, beginning 6 weeks postsurgery, and remaining statistically significant and clinically meaningful through the 5-year follow-up. The study was designed to satisfy regulatory requirements, and survival was defined, a priori, in the study protocol with US Food and Drug Administration to be freedom from conversion to arthroplasty or high tibial osteotomy. At 5 years, 73\/81 (90.1%) participants reported conversion-free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>ISA provided benefits that were statistically significant and clinically meaningful for at least 5 years. Based on these 5-year data of durable, conversion-free survivorship, the ISA has proven to be a treatment option for medial knee osteoarthritis patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.oa.25.00187","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T18:06:14Z","timestamp":1781546774000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["5-Year Results of an Implantable Shock Absorber Demonstrate Durable Outcomes in Patients with Medial Knee Osteoarthritis"],"prefix":"10.2106","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3634-4871","authenticated-orcid":false,"given":"Anil","family":"Ranawat","sequence":"first","affiliation":[{"name":"Hospital for Special Surgery, New York, New 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