Nonsurgical Relief for Younger Adults With Refractory Knee Osteoarthritis

Younger adults below the age of 65 years who have started showing symptoms for knee osteoarthritis but not enough to warrant arthroplasty may be able to seek relief with implantable shock absorber (ISA), findings of a 2-year study suggested. The results of the study are published in the Cartilage.

“Up to 10 million Americans below the age of 65 years have symptomatic knee osteoarthritis and may not yet be candidates for arthroplasty. In response, a subcutaneous ISA that unloads the knee has been developed,” the team of 5 researchers explained. “Treatment with ISA has high clinical benefit and is durable through at least 24 months.”

For this prospective open-label cohort study, the researchers evaluated the safety and effectiveness of the new ISA treatment versus that of a surgical high tibial osteotomy (HTO). Over 2 years, the study collected data on the pain and function outcomes of 81 young adults aged 25-65 years who showed symptoms of knee osteoarthritis.

The composite variable combining pain, function, specific adverse events, integrity of implant or hardware, and conversion to subsequent surgery, were measured on the Western Ontario and McMaster Universities Arthritis Index.

They found that 85.6% of all ISA participants met the criteria compared to 65.5% of HTO participants. For pain, 95.8% of the ISA group responded better vs 87.9% of the HTO group. Similarly, for function, the ISA group responded better than the HTO group (91.7% versus 81.3%).

Even with the secondary endpoints, the ISA group demonstrated superiority over the HTO group, proving that ISA was a good option for younger adults who are not yet qualified to go for knee replacement surgery.

 —Priyam Vora

Reference:
Diduch DR, Crawford DC, Ranawat AS, Victor J and Flanigan DC. Implantable shock absorber provides superior pain relief and functional improvement compared with high tibial osteotomy in patients with mild-to-moderate medial knee osteoarthritis: A 2-year report. Cartilage. Published online: February 23, 2023. DOI: 10.1177/19476035231157335