Use of a Medial Knee Implantable Shock Absorber

This policy addresses use of a medial knee implantable shock absorber (e.g., MISHA Knee System) for treatment of medial-compartment knee osteoarthritis to reduce medial joint loads and improve symptoms in patients with mild-to-moderate symptomatic disease who have failed prior surgical or non-surgical treatments per FDA authorization. However, these devices are considered experimental/investigational and not covered for routine clinical use—coverage is limited to use within research or clinical trials comparing to existing management due to very limited evidence (one case series and three case reports), and final coverage is subject to the member’s benefit contract and local Medicare carrier discretion.

"Treatment of medial compartment knee osteoarthritis to reduce loads on the intraarticular medial joint surface and improve symptoms."

Sign up to see full coverage criteria, indications, and limitations.