The Question That Started It All: The Science Behind a New Way to Treat Knee Osteoarthritis
March 2026
Most breakthroughs in healthcare begin not with a new machine, but with someone noticing a problem that everyone else had quietly accepted.
The origin of Apos – the biomechanical treatment for knee osteoarthritis we offer here at the clinic – is exactly that kind of story.
A pattern that didn't add up
In the early 2000s, two clinicians, Dr. Avi Elbaz and Dr. Amit Mor, were treating patients with knee osteoarthritis (OA) and kept running into the same frustrating wall. Their patients were doing everything asked of them (strengthening exercises, braces, orthotics, medication), and yet one of the most basic activities of all still hurt: walking. Pain during gait was barely shifting at all.
At the same time, clinical research was changing how OA was understood. Studies were showing that osteoarthritis wasn't simply a matter of cartilage "wearing out". People with OA also had altered movement patterns, weakened muscle control, joint instability and the muscles around the knee clenching against each other – all of which actually drove the condition on.
In other words, OA was starting to look as much like a problem of movement as a problem of structure.
That reframing led to a deceptively simple question:
If the two biggest drivers of knee OA – joint load and muscle control – are both biomechanical, why aren't our treatments?
To answer this, the pair worked with engineers, gait scientists, biomechanics labs and the Technion (Israel Institute of Technology), with one clear goal: to change how people actually walk, in everyday life, in order to change both their symptoms and their long-term outcomes.
Why the usual approaches only got halfway
Conventional treatment options like braces, insoles, walking aids, exercise programmes are built on sound ideas. But each tends to tackle only one side of the problem. Some try to reduce the load going through the joint; others try to improve muscle control. Rarely do they do both, and rarely do they do it dynamically, while you're moving.
A brace or insole changes things in a fairly fixed, static way. Exercise builds strength, but it happens in short bursts, often isn't comfortable when the joint is already loaded, and can be hard to stick with.
The missing piece was an approach that reduced harmful load and retrained the muscles at the same time, during natural, real-world walking.
That gap is what Apos was created to fill.
The idea behind the Apos device
The Apos solution looks surprisingly ordinary: a pair of shoes fitted with adjustable convex pods under the heel and forefoot. The clever part is what those pods let a clinician do: fine-tune where pressure falls under your foot, and in doing so, change the forces travelling up through the knee as you walk. Adjustments are bespoke to you and can be tuned in real time.
This matters because of something researchers call the “knee adduction moment”, or KAM. KAM is one of the strongest biomechanical markers linked to the severity and progression of knee OA on the inner (medial) side of the joint, where wear is most often concentrated.
Higher KAM is associated with more pain, faster functional decline and more progression on X-rays. Crucially, KAM is modifiable. By repositioning the pods by just a few millimetres, a clinician can shift your centre of pressure and ease the load on the painful part of the joint. And if the mechanics can be changed, so can the symptoms of knee OA.
The hidden benefit: relearning how to walk
Reducing load was only half the story. The gently curved Apos pods also introduce small, controlled challenges to your balance with every step. This nudges your body's positional awareness and muscle coordination to adapt – essentially a high-frequency, real-life form of motor learning, repeated naturally as you go about your day.
Over time, as pain eases and movement improves, patients begin to walk better even when they aren't wearing the device. For many people, that's the real shift: rehabilitation stops being something that only happens during a clinic appointment and becomes something woven into ordinary daily life.
What the evidence says
The AposHealth approach is now supported by more than 70 peer-reviewed publications, including randomised controlled trials, prospective controlled studies and long-term cohorts.
Across that body of research, the findings point consistently in the same direction: meaningful reductions in pain, improvements in day-to-day function and quality of life, better gait (things like walking speed and step length), healthier biomechanical markers, and improved muscle activation patterns.
For knee OA care in the UK, where pathways are stretched and long-term results can be inconsistent, AposHealth offers something genuinely useful: an approach that challenges the assumption that knee OA is simply an inevitable decline, and treats it instead as something that can be actively influenced.
Could AposHealth help you?
If you've been living with knee osteoarthritis and feel you've tried everything short of surgery without any lasting relief, it may be worth understanding whether the AposHealth approach fits your situation. The right starting point is a proper assessment of how you move.
Get in touch with our team to arrange a gait assessment, and we'll talk you through whether Apos (or another part of our musculoskeletal care) is the right next step for you.
This article is for general information only and does not constitute medical advice. Always seek the guidance of a qualified healthcare professional regarding any medical condition or treatment. Individual results vary.
