An ossicular replacement prosthesis includes first and second engagement structures for engaging middle ear structures, a spring that biases the first and second engagement structures longitudinally apart when under compression, and a rod that axially stabilizes longitudinal movement of the first and second engagement structures and conducts sound waves between the first and second engagement structures. Relative axial pressure on the first and second engagement structures causes compression or expansion of the spring which results in movement of the rod to adjust the length of the prosthesis to accommodate changes in anatomical distance as occurs under changes in pressure or abnormal middle ear conditions.
