A step forward in knee pain treatment

Patients in Merseyside are benefiting from life-changing relief from knee pain and osteoarthritis thanks to a ground-breaking medical device.

The Apos® personalised shoe is worn for around an hour a day to help patients retrain their muscles and improve the way they walk.

The device is being made available thanks to the MedTech Funding Mandate (MTFM), a funding arrangement backed by Health Innovation North West Coast. 

So far, 22 patients have benefited from the treatment after it was adopted last year by the knee clinic at Wirral University Teaching Hospital NHS FT.

One of them is Ian, a patient from Wirral, who said: “In the past I was struggling with constant pain. I couldn’t really walk very far. I tried cortisone injections and co-codamol, naproxen, tablets like that, but really they don’t touch the pain.

“I’ve been using the Apos® shoe for about 18 months. When I’m wearing the shoe my pain virtually disappears. It’s changed my outlook.”

The shoe is fitted with circular ‘pods’ on the heel and forefoot which can be adjusted according to the patient’s gait. It tackles the underlying causes of pain by shifting pressure from affected areas and ‘re-educating’ the muscles so the individual adopts a healthier pattern of walking.

The shoe offers an alternative to steroid injections and to surgery, which some patients do not want.

Darcie May, Clinical Lead Orthotist at Wirral University Teaching Hospital NHS Foundation Trust, said: “We have successfully used this intervention for several of our patients. It is allowing us to tap into different patient demographics who are not suitable or do not desire knee-bracing, such as our lymphedema patients (within reasonable fitting of the shoe).

“However, I would say Apos® shoes are most popular with our patient demographic who are most active at home, rather than outdoors, therefore they are compliant with using the Apos® shoes as their 'indoor shoes' for an hour a day.”

Steve Adams, Commercial Programme Manager at Health Innovation North West Coast, said: “The funding mechanism aims to ensure that effective treatments are adopted as quickly as possible. Our role is to drive the adoption process, so we’re pleased we’ve been able to do that in this case.

“Apos® is an alternative treatment for people who are running out of options and improves their mental health while reducing their dependency on pain medication.”

Rhiannon Clarke, Senior Programme Manager at Health Innovation North West Coast, said: “The Apos® shoe is a tried and tested device which has already proved its worth and is approved by NICE, so we were only too happy to work with our partners to make sure patients could benefit from it.”

Musculoskeletal (MSK) conditions cost health services around £10.2bn a year, or five per cent of the NHS’s total costs. Around 8.5m people in the UK suffer from osteoarthritis, or 12.5 per cent of the population.

MSK conditions are the leading cause of pain and disability in England, accounting for one of the highest causes of sickness absence. According to Government research, less than 20 per cent of people aged 16 and over self-report for long-term pain and so continue to live with their condition.

The MTFM  policy supports NHS priorities by accelerating the adoption of selected NICE-recommended, cost-saving medical devices, diagnostics and digital products, so patients gain access to these technologies across England by removing funding barriers. 

You can learn more in this short film from NHS Supply Chain which was filmed at Wirral University Teaching Hospital NHS Foundation Trust.