Providing effective and cost efficient knee treatment is one of the most important challenges facing the healthcare industry in the UK. It is a heavy burden to juggle budget and demand management alongside treatment effectiveness, safety, patient adherence and satisfaction whilst complying with national policies. AposHealth® is clinically and financially proven to help CCGs and patients carry the heavy burden of knee pain more efficiently.

Case Study: £1.4 million savings + improved clinical outcomes

By implementing AposHealth a mid-sized CCG was able to avoid £1.4m in surgical costs whilst improving clinical outcomes using a Risk/Gain model. In 2017, the mid size CCG began commissioning AposHealth as part of its knee osteoarthritis pathway. KPIs set by the CCG were met and exceeded.

High patient satisfaction rates were desired. The mid sized CCG defined satisfaction rates as ‘high’ as long as >85% of patients would recommend the treatment. Based on regular surveys of patients in treatment, a remarkable 98% of patients said they would recommend the treatment programme to friends and family.
Operational KPIs—including patient satisfaction feedback on: initial contact, initial consultation, FU appointments, DNAs, communication to GP and duty of candour—were all met with distinction.

  • 98% of the patients reported excellent/very good service
  • 99% of the patients were seen on time or within 5 minutes of the appointment time
  • 95% of the patients feel confident that they can contact the clinic for any questions
  • 99% of the patients feel that the treatment programme was explained clearly

Clinical KPIs (including Oxford Knee score, WOMAC score, computerised gait measurements) were determined to assure that patients experienced significant alleviation in pain and improvement in daily function.

These KPIs were met and exceeded with AposHealth:


Oxford Knee Score

7 points improvement

9.5 points improvement


At least 17% improvement in pain and function, or 10 points (whichever is greater) for 70% of patients

An average of 50% improvement, with 85% of patients meeting this KPI

Gait Improvement

Clinically significant improvement in objective gait measures (measured by 10% increase in gait velocity)

16% increase in gait velocity


Delay or altogether avoid surgery for 75% of patients (< 25% failure)

92% avoided surgery

Between November 2017 – Nov 2019, 361 patients were treated with AposHealth in the CCG, with only 28 of these patients (8%) progressing to secondary care consultation.

Key Benefits of AposHealth

AposHealth is a CE cleared, effective, non invasive treatment that treats both the symptoms and root causes of persistent knee conditions, reducing pain and improving mobility – without the risks of surgery or the potential side effects of medicine, and without disrupting the patient’s daily routine.

Key benefits of AposHealth include:

  • Clinically proven – AposHealth has over 50 published studies supporting its treatment principles and beneficial clinical effects, which include significant reduction in pain, improvement of function and gait velocity, alongside the avoidance of surgery.
  • Cost effective – AposHealth costs less than 1/3 of the cost of a knee replacement
  • Safe – AposHealth avoids the risks associated with invasive treatments. Clinical experience indicates that any side effects are minimal and rare and may manifest in mild fatigue and muscle spasms. In rare cases where these appear, they pass very quickly as treatment progresses.
  • Short waiting times – Patients are seen within 1 month of referral.
  • High patient satisfaction rates – 98% of the patients are extremely likely/likely to recommend AposHealth to friends and family.
  • Delays and/or avoids surgery
    • Low decay rate – Only 8% of compliant patients progress to a Secondary Care consultation.

How AposHealth Works

AposHealth is based on a footworn medical device that distributes pressure away from the affected area by changing the foot’s point of contact with the ground.

The AposHealth device is composed of convex, adjustable Pods placed under the hindfoot and forefoot regions of each foot. These elements are attached via a platform in the form of a shoe. The platform enables a trained physiotherapist to provide custom calibration of the Pods. The positioning of the Pods changes the location of the centre of pressure, changing the moments acting within the kinetic chain. The device is used during normal activities at home, allowing the alignment and controlled perturbation to be applied repetitively and dynamically throughout all phases of each step.

Over time, AposHealth re-educates the neuromuscular system to maintain the improved walking patterns even while not wearing the device.

Here is a video that explains how it works in a little more depth.

How AposHealth Provides Value to CCGs

(Reduction and avoidance of costs, improved results, more efficient waiting list management, low financial risk)

AposHealth provides significant pain relief and effective patient outcomes to help support those who cannot or should not receive knee replacement surgery. With high efficacy, safety, patient outcomes, compliance and satisfaction rates, With high efficacy, safety, patient outcomes, compliance and satisfaction rates, AposHealth can help CCGs comply with national policies and KPIs.

An innovative treatment that gives CCGs the power to reduce costs associated with knee surgery and persistent knee pain treatment, whilst managing waiting lists and reinvesting the avoided costs, AposHealth provides additional value by:

  1. Reducing costs associated with persistent pain management in the MSK pathway
  2. Allowing CCGs to reinvest the avoided costs of MSK treatment into other areas
  3. Helping CCGs manage patient waiting lists for surgery, providing capacity based on clinical need
  4. Mitigating the risk of investment by reimbursing the patient’s treatment if they progress to surgery
  5. May help the CCG in managing post-surgical persistent pain (30% of all knee replacements)

The Uniqueness of AposHealth

Based on the latest evidence regarding the central role biomechanics plays in MSK conditions, AposHealth distributes the patient’s body weight away from the affected area of the knee joint. This reduces the compressive forces and therefore, the pain.

Developed by orthopaedic and sports medicine specialists, AposHealth integrates with the patient’s normal routine and requires only around one hour of use daily. The patient is monitored throughout the course of their treatment programme by an AposHealth physiotherapist. As the patient’s gait and symptoms improve, the physiotherapist adjusts the device to stimulate continued gait improvement and pain relief.

AposHealth allows the patient to go about their regular routine whilst the treatment works subconsciously. By introducing mild instability as the patient walks, the therapy retrains the muscles to provide pain relief, better joints stability and better movement patterns.

Patient Satisfaction

AposHealth patients have remarkably good things to say about the treatment programme. Many patients experience pain relief starting from the first time they wear the device. And patients gush about being able to avoid surgery whilst getting back to the things they love to do. Here is a montage of patients’ stories.

And for more testimonials, please see our Patients Stories page.


AposHealth, being a conservative modality, is a safe treatment and there are no documented adverse events. It is important to stress that patients are thoroughly assessed by a trained physiotherapist for risk of falling and the application of treatment is only for those patients who it is suitable for. Therefore, the treatment programme is a safe investment in addition to its many added benefits.

The Bottom Line

Just as one mid sized CCG commissioned AposHealth for the knee osteoarthritis pathway and was able to:

  • reduce and avoid costs,
  • provide excellent clinical results,
  • increase the efficiency of waiting list management,
  • at low financial risk,

Other CCGs, too, can do the same. Moreover, offering this treatment programme can positively influence patient satisfaction for the providing CCG, as 98% of patients said they would recommend AposHealth to friends and family. To download a short report with more information about how to begin offering AposHealth, please fill in the below form.

Download the short guide to find out how much your CCG could save