Improving patient outcomes with knee osteoarthritis

Apos Health is a foot worn medical device that helps people with knee, hip and lower back pain relating to osteoarthritis.

Knee pain relating to osteoarthritis effects 5.4 million of the population and is more prevalent and severe in women. To treat it, NICE recommends exercise, weight management and sometimes walking aids or medication. For milder cases, these treatments are effective, however if symptoms worsen, surgery can be offered.

A knee operation can be painful and invasive and often has residual complications. Co-morbidities and weight restrictions mean that not everyone is suitable for surgery, so having an effective alternative is important.

The device provides an alternative option to surgery where first line treatment has not been effective and it’s use may delay the need for surgery for several years.

Introduced to the UK in 2010, the medical device has two parts mounted on rails that calibrate to patients needs following a gait assessment. The device changes the forces acting on the knee to reduce pain and helps retrain the muscles around the knee to work more efficiently.

Journey to market

By registering the product with the NHS Innovation Service, the company were able to access support from NICE, NHS Supply Chain and the Health Innovation Network.

An independent randomised control trial on the clinical effectiveness of the device was published in the Journal of the American Medical Association (JAMA), a peer-reviewed medical journal. NHS Innovation Service partners provided advice that helped the company collect real world evidence, off the back of this work.

Partners also advised the company to actively involve patients and the public to help refine where and how the product could offer the most value to meet patient needs.

NICE selected the innovation to be assessed under the NICE MedTech Evaluation programme, which resulted in guidance recommending the device as a cost-saving solution for a particular cohort of people. NHS Supply Chain helped direct the company towards finding a distributor, which meant Apos Health could then get on the supply chain.

The device is now recommended by NICE for knee osteoarthritis patients who meet the criteria for joint replacement surgery and who have not responded adequately to the recommended NICE therapies.

The innovation has been selected as part of the MedTech Funding Mandate for national adoption for 2024/25.

The patient perspective

Six years ago, Christine Harpur, from Northern Ireland, struggled with bad knees to the point where she could hardly walk, and knee replacement surgery was recommended. However, Christine was not keen on the idea of surgery. She became aware of the product and after consulting with her physiotherapist decided to give the device a try.

The result has been life changing for her: