NICE release draft recommendation on shoes for osteoarthritis

The National Institute for Health and Care Excellence (NICE) has released a draft recommendation on innovative footwear to support people with severe knee osteoarthritis.

The specially adapted shoes are called Apos and have been developed by AposHealth. They aim to improve the biomechanics of the patient by redistributing pressure away from affected areas. The shoes are fitted with rubber ‘pods’ intended to help in re-educating muscles and correcting abnormal walking patterns. Trained healthcare professionals can position the pods after analysis of walking patterns to adapt the shoes to individual requirements.

It is currently estimated that one in five people aged 45 or over have knee osteoarthritis in England. Current non-surgical aids include walking sticks and therapeutic exercises; it is hoped that the new devices will better assist with relieving symptoms such as painful, stiff joints.

Analysis from the independent NICE medical technology advisory committee indicates that the shoes could potentially save the NHS £1,958 per person in comparison to standard care over five years. The committee has recommended the footwear for people for whom non-surgical standard care has not worked well, and who meet the referral criteria for total knee replacement surgery but cannot have or do not want it.

Whilst clinical evidence collected from a high-quality randomised controlled trial shows improvements in scores for pain, stiffness and function from people using the Apos shoes, the committee has called for further data on quality of life, health resource use and long-term surgical outcomes.

NICE recommendations do not include a funding mandate, so it is up to local commissioners to decide whether or not they wish to implement the recommendations.

Consultation has started on this recommendation on NICE’s website, and will run until Monday 12 December 2022.