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Value Proposition

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What is AposTherapy® and How Can it Help Support My CCG or Trust?

AposTherapy® (Apos – All Phases Of Step) is a treatment plan that has been developed in Israel, and is positioned for patients with chronic knee pain who have already tried conservative treatments but still experience significant symptoms which impact negatively on activities of daily living. It works by simultaneously addressing the biomechanics and neuromuscular control with the aim of reducing pain and restoring optimal movement. It has been available in the UK for 9 years and is covered by several leading insurers with over 60,000 people internationally having been treated.  The treatment plan consists of in-depth assessment, continual measurement of outcomes such as gait and PROM’s and the expert calibration and provision of a biomechanical foot-worn device by specially trained physiotherapists.

Patients conveniently only wear the device for short periods of time (about an hour) during their normal daily activities in order to establish neuromuscular learning over time.  The treatment has been thoroughly researched with over 30 published papers including independent prospective studies.  Importantly patients themselves have reported an 87% decrease in pain, an 88% increase in mobility and 92% would recommend the treatment to Friends and Family.

A two-year study in Israel measuring the impact of AposTherapy® against current conservative modalities has indicated there are significant benefits in the use of the system to support management of pain and function. Both groups were selected from a group of participants who reported recent similar levels of bilateral knee pain with radiographic signs of osteoarthritis. The AposTherapy® group reported improved pain management and function.  Over a two-year period, just 2.5% of the active group required knee replacement, against 31.25% in the group receiving current treatment options.

We know from patients who are funded by their Private Medical Insurers that only a low percentage of users go onto require orthopaedic intervention over a defined period of time.

“Real World” outcomes from our current NHS Projects are showing good clinical outcomes for a population that would otherwise be candidates for total joint replacements.  Thereby providing an effective, non-invasive alternative for the patient whilst reducing the requirement of more invasive treatments such as TKR/THR surgery.

Cost benefits for the NHS with the inclusion of AposTherapy® into the knee pathway

The cost of the AposTherapy® programme is significantly lower that of a total knee replacement, which includes a full assessment and gait analysis, and 12 months of focused support to re-educate the muscles to ensure optimal movement and then an ongoing maintenance programme.

With outcomes indicating a significant reduction in pain, improvement in mobility and reduction in progression to total knee replacement this does indicate significant value for money. Treating patients with AposTherapy® instead of TKR is cash releasing and could reduce direct cash spend by over 50% over 3 years compared with conducting knee replacements for the same population.

Example: A provider installs AposTherapy® into the MSK pathway and as such triages suitability for AposTherapy® based on known clinical indicators. AposTherapy® is delivered for approximately 275 patients. It is accepted that a low percentage will not succeed with AposTherapy® and therefore we share the risk and gain around that decay rate. Based on an average tariff of £6,000, a CCG could reasonably expect to save £2.4M over the above population over a 3-year period.

There would also be ongoing savings in primary care with a reduction in GP appointments, prescriptions of analgesia, and recurrent physiotherapy treatment programmes. Plus the potential to reduce the volume of revision surgeries in years to come. Benefits for the individual would include improved ability to undertake work and leisure activities and reducing the number of times taken off work with knee pain.

For further information on a bespoke model for your healthcare economy please contact Lior Lugassy at or + 44 (0)7808 366906