The Memo: Moximed Building a New Treatment Paradigm for Knee Osteoarthritis

Under the direction of President and CEO Christopher Gleason, Moximed is advancing a joint-preserving approach to knee osteoarthritis with the MISHA Knee System, an implantable shock absorber designed to unload the medial compartment of the knee without replacing the joint. Built on nearly two decades of clinical development and more than a decade of technology refinement, MISHA is intended to address a substantial gap between conservative care and knee arthroplasty. Now commercially available in the U.S., Moximed is focused on scaling adoption, expanding its body of clinical evidence, and establishing joint unloading as a new treatment paradigm for patients who have exhausted non-surgical options but are unwilling to undergo or are not indicated for knee replacement.

Origin Story

Moximed was co-founded by Anton Clifford, PhD, and LSI Alumni Josh Makower, MD, around a straightforward biomechanical premise: reducing the forces acting across an osteoarthritic knee could address an important mechanical driver of the disease without sacrificing the native joint.

“Anton and Josh saw that the orthopedic field was solving end-stage OA with joint replacement and that an opportunity existed to address the underlying mechanical problem earlier in the disease process,” Gleason explained. “They created Moximed to prove that a joint-sparing device could change the loading environment of the knee and return patients to pre-disease activity levels while keeping their knee intact.”

That vision ultimately led to MISHA, an extracapsular implant designed to absorb excess forces across the medial compartment of the knee.

Gleason joined Moximed after building much of his career around bringing disruptive medical technologies into clinical practice. He previously helped create and grow businesses at NeoTract, acquired by Teleflex, and Relievant Medsystems, acquired by Boston Scientific.

“Commercializing completely new and different approaches to help with gaps in treatment, where no solution is ideal for patients and doctors, all the way through to standard of care has been the focus of my career,” Gleason said.

Moximed represented an opportunity to do that again in a large orthopedic market with a significant unmet need.

“At Moximed, we have the capability to have an incredibly meaningful effect on patient lives worldwide.”

The Current Landscape

According to Moximed, approximately 15 million patients in the U.S. live with symptomatic knee osteoarthritis, a progressive condition that can substantially affect mobility, activity, and quality of life across both younger and older patient populations.

The challenge is not simply the number of patients. It is the gap between the treatment options available as the disease progresses.

Moximed estimates that approximately 30% of these patients are treated with conservative approaches such as knee braces, hyaluronic acid injections, and physical therapy. At the other end of the spectrum, approximately 8% have reached the point at which surgical options such as unicompartmental knee arthroplasty or total knee arthroplasty may be appropriate.

Between those groups are an estimated 9 million patients, representing 62% of the symptomatic population, who may have exhausted conservative care but are not yet candidates for, or do not want, knee replacement.

According to Moximed, patients remain in this treatment gap for 13 years on average.

Of those 9 million patients, the company estimates that roughly 4 million fit the current indication for MISHA: patients with activity-restricting pain who have failed non-surgical care and are unwilling to undergo, or are not indicated for, knee arthroplasty.

Rather than replacing the knee earlier, Moximed is pursuing a fundamentally different strategy: change the mechanical environment inside the joint while preserving the patient’s anatomy.

Inside the Innovation

The MISHA Knee System is an implantable shock absorber designed to unload the knee joint, reduce pain, and improve function in patients with medial knee osteoarthritis.

“Founded on the principle of joint unloading, the MISHA Knee System is an extracapsular implant that preserves anatomy while sharing the load with the medial knee joint,” Gleason explained. “Articulating ball-and-socket joints allow the device to accommodate the natural kinematic motions of the knee, while absorbing excess forces when the leg is extended and often supporting the most weight.”

Because MISHA sits outside the joint capsule, the approach is designed to preserve the native anatomy rather than resecting bone and replacing the articular surfaces. According to Moximed, the implanted shock absorber provides greater than a 30% reduction in peak knee pressure.

That distinction is central to the company’s strategy. Instead of positioning MISHA as another conservative therapy or an alternative form of arthroplasty, Moximed is seeking to establish a new mechanical treatment category between the two.

“We offer a joint-sparing mechanical solution for a significant unmet need,” Gleason said.

The technology is also supported by an expanding body of clinical evidence. Five-year clinical data published in JBJS demonstrated sustained, clinically meaningful improvements in pain and function among patients treated with the implantable shock absorber, providing longer-term evidence for an approach Moximed has spent more than a decade refining.

Progress and Milestones

Moximed is now a commercial-stage company focused squarely on the U.S. market. The MISHA Knee System has received FDA clearance with Breakthrough Device designation, and the company is building the clinical, reimbursement, and commercial infrastructure needed to support broader adoption.

Reimbursement has become an increasingly important part of that foundation. The MISHA Knee System received a facility C-code effective in 2025, and Moximed says it was granted a Category I CPT code in 2026 that will become effective in January 2027.

At the same time, longer-term clinical evidence continues to mature. Five-year results published in JBJS showed statistically significant and clinically meaningful improvements from baseline in WOMAC pain and function through five years. The study also reported 90.1% freedom from conversion to arthroplasty or high tibial osteotomy at five years.

For Moximed, those milestones are converging as the company moves from proving the technology toward scaling it.

“The company is focused on delivering best-in-class U.S. commercial execution and investing in commercial programs as well as future product enhancement and next generations,” Gleason said. “In terms of major company developments, you should expect continued investments in clinical evidence, targeted scaling of its commercial engine, and future product launches.”

Moximed is also seeing continued quarter-over-quarter commercial momentum, according to Gleason, alongside growing patient demand and physician interest.

As Moximed enters its next phase, Gleason is also looking outward for lessons from other medtech leaders and potential partners for the company’s continued growth.

“At LSI Europe, we are looking to learn from other peers on best practices as we scale and to connect with potential investors who are a fit for our next future financing round.”

Join Us at LSI Europe ‘26

Gleason has been selected to present at LSI Europe '26, September 28th–October 1st, in front of hundreds of global medical technology companies. Join us in welcoming him to the event in Barcelona, where he will share the latest updates on Moximed’s technology and development.