Indiana Debuts Implantable Shock Absorber for Knee Osteoarthritis

By Sharon Kelly

CHESTERTON, IN – April 20, 2026 – A new era in orthopedic care has arrived in Indiana, offering a beacon of hope for thousands suffering from the debilitating pain of knee osteoarthritis. Lakeshore Bone & Joint Institute (LBJI) has announced that Dr. Anthony C. Levenda, a partner and orthopedic surgeon at the practice, has successfully performed the state's first procedure using the MISHA® Knee System. This landmark surgery, conducted at the Lakeshore Surgicare ambulatory center, introduces an innovative implantable shock absorber designed to relieve pain while preserving the patient's natural knee joint.

The introduction of this technology marks a significant advancement for patients who find themselves in a difficult middle ground—those for whom conservative treatments like physical therapy and injections have failed, but who are not yet ready for, or wish to avoid, a total knee replacement.

A New Frontier in Knee Pain Relief

Knee osteoarthritis affects over 18 million people in the United States, with more than half of them under the age of 65. For this younger, more active demographic, the prospect of a total knee replacement—a major surgery that involves removing bone and cartilage—can be daunting. It often means significant lifestyle changes and the potential for future revision surgeries. This has created a well-known “treatment gap” in orthopedic care.

The MISHA Knee System is engineered specifically to fill that void. It functions as an external support mechanism that unloads the knee without altering the joint itself.

"With the MISHA Knee System, we offer patients a joint-preserving solution designed to reduce pain and improve function without removing healthy bone or tissue," said Dr. Levenda in a statement. "It's an exciting advancement that fills the gap between non-surgical care and total knee replacement, giving patients a new option to stay active and improve their quality of life."

This approach directly targets the mechanical stress that is a root cause of osteoarthritis symptoms, offering a durable solution that was previously unavailable.

How the Implantable Shock Absorber Works

Unlike traditional knee surgeries, the MISHA system is not a replacement but a reinforcement. Drawing an analogy to a car's suspension, the device is an implantable shock absorber (ISA) that reduces the peak forces on the knee joint by over 30% with every step. The compact implant, measuring about two inches long, consists of a small steel piston inside a polymer cylinder. It is attached to the thigh bone (femur) and shin bone (tibia) with titanium plates.

Crucially, the entire device is placed outside the knee joint capsule, under the skin and muscles on the inner side of the knee. This extracapsular placement is its key innovation. It allows the implant to move in concert with the knee's natural motion without disturbing the joint's anatomy. No bone, ligament, or cartilage is removed during the procedure.

This method stands in stark contrast to alternatives. A total knee replacement resurfaces the entire joint, while a high tibial osteotomy (HTO)—a common joint-preserving surgery—involves cutting and realigning the tibia to shift weight off the damaged cartilage. While effective, HTO is significantly more invasive and requires a much longer recovery. The MISHA system's design preserves all future treatment options; if a patient eventually needs a total knee replacement, the implant can be removed without complicating the subsequent procedure.

Clinical Evidence and Patient Experience

The MISHA Knee System received marketing authorization from the U.S. Food and Drug Administration (FDA) in April 2023, backed by robust clinical data. A pivotal study, known as the Calypso Study, demonstrated its superiority over HTO. After two years, 96% of MISHA patients reported significant pain improvement compared to 88% in the HTO group. The MISHA group also saw fewer complications and a dramatically faster recovery.

Patients receiving the implant were able to bear their full weight in an average of 13 days, compared to nearly two months (58 days) for those who underwent HTO. Many MISHA procedures are performed on an outpatient basis, allowing patients to return home the same day.

Ideal candidates are typically active individuals between 25 and 65 years old with pain primarily on the inner (medial) side of the knee who have not found relief after at least six months of non-surgical care. The system is not intended for those with inflammatory arthritis or advanced, "bone-on-bone" arthritis across the entire joint. While generally well-tolerated, potential side effects can include temporary pain, stiffness, or numbness at the surgical site. Long-term studies show an 85% rate of freedom from conversion to a knee replacement at five years, underscoring its potential as a durable, long-term solution.

Pioneering a New Standard of Care in Indiana

By being the first to bring this technology to the Hoosier State, Lakeshore Bone & Joint Institute, a practice serving northwest Indiana since 1968, solidifies its position as a regional leader in orthopedic innovation. The move reflects a broader shift in orthopedics toward joint preservation and more personalized patient care.

"The MISHA Knee System reflects our continued commitment to advancing the patient experience across every stage of care," noted Thor Thordarson, MBA, RN, in the announcement. "By thoughtfully integrating advanced, joint-preserving technology into our practice, we continue to evolve how we care for patients, offering more personalized treatment approaches that support stronger outcomes and help patients get back to the activities they enjoy."

The availability of this procedure in Indiana not only expands the treatment continuum for local patients but also has the potential to influence regional healthcare economics. By delaying or preventing the need for more costly and complex total knee replacements, this less invasive, outpatient-friendly procedure could lead to long-term cost savings for the healthcare system while delivering immense quality-of-life benefits to patients eager to remain active and pain-free.