At least one embodiment is directed to an insert sensing device for measuring a parameter of the muscular-skeletal system. The insert sensing device can be temporary or permanent. The insert sensing device is a self-contained encapsulated measurement device. The insert sensing device comprises a support structure having an articular surface for allowing articulation of the muscular-skeletal system and a support structure having a load bearing surface. The structures attach together to form a housing that includes one or more sensors, a power source, electronic circuitry, and communication circuitry. Shims can be attached to the load-bearing surface to adjust the height of insert sensing device. The structures are substantially dimensionally equal to a passive final insert. The sensors are placed between a pad region and a load plate.