America doesn’t issue Ballistic knives they are a novelty item. One with lots of restrictions. From a Shooting perspective shooting knives are a piss poor option. In ergonomics recoil they lack any means of mitigation the needs of the shooting mechanism means the grip is larger and not an ergonomic shape. In accuracy the sighting system is inferior as the short sight base at best only allows a single ring sight only suited to very close range engagement. Magazine capacity is such that you only get 1 to 4 shots which is a sick joke.
As a Blade the knife has issues as the blade has to sacrifice rigidity and strength for the firing mechanism. The mechanism also adds unnecessary weight. Even the Soviets at a point realized the limitations of the novelty and built an iteration that replaced the gun with a survival kit. Which would still have compromises but far less so.
The concept is at its heart loaded with comprises, Comprising the utility for basically a novelty.
When the Russians introduced it they had better options just the Makarov alone would be far superior for a concealable gun. If you want a knife the old NR40 knife on which the Russian blade was based. The PLA has better options to.
This is one of those cases like the Christy Suspension on tanks. Building a tank with a ride like a Grand tourer sounds great but it ate up storage and crew space, limited growth potential and never really was easy to swap between tank track and car wheels. Never managed to get the desired speed and couldn’t accommodate larger turrets and guns. Long run in battle it was used but only until better options could be designed.