Monday, May 7, 2007

The APOS System for Knee Osteoarthritis

Filed under: Orthopedic Surgery , Rehab

The APOS system, developed by APOS Medical and Sports Technologies Ltd. of Herzliya, Israel, can "significantly improve pain and function in patients with knee osteoarthritis (OA)--sometimes immediately," according to a statement by the American Academy of Orthopaedic Surgeons, after results from a double blind study were published at the society's 2007 annual meeting poster presentations. The device's benefits likely come from its design that eliminates flat surface walking.

The APOS system... looks like a makeshift type of rollerskate - with two half-balls protruding from the shoe's base. But it's anything but a toy.

Developed over eight years by Drs. Amit Mor and Avi Elbaz (from the Assaf Harofe Medical Center in Tel Aviv), the APOS shoe has been clinically proven to both improve the patient's gait and alleviate the pain in the knee and other leg joints...

"Basically the way joint rehabilitation has been carried out over the last 50 years or so hasn't change," Mor explained. "The most important issue is functional rehabilitation - the simulation of life and environment. For example, what do you want an injured person to be able to return to do? To be able to go out and walk in the supermarket. But what current rehabilitation methods have been doing is showing them how to stand in the clinic. We wanted to be able to simulate real life."

Mor explained that for the first few thousand years of man's existence, there wasn't a problem with neuro-muscular control - people walked in sand, mud, natural platforms that went up and down in natural inclines and declines, forcing people to use all their muscles equally.

"Nowadays, with Crocs, Nikes, and all the artificial flat surfaces made of parquet or carpet, everything is level, and every step we take is no different from the last thousand steps, or the next thousand steps. In addition, we all sit near a computer where we work in unnatural settings - the result is osteoarthritis, back pain," said Mor.

"Our aim was to simulate the way mammals rehabilitated in nature and evolution but we wanted to KISS - keep it simple. We wanted to connect the hemispheres under the hind and fore foot," he added, explaining that a hemisphere creates multi-directional instability and has been the general practice for decades in simulating instability for patients.

The result is the APOS footwear that involves the use of semispherical, individually calibrated bio-mechanical units that are placed on the soles of the shoes at the hindfoot and forefoot. These units can move medially, laterally, forward, and backward, and may be individually adjusted in order to balance loads.

The APOS individually calibrated shoes provide dynamic wedging, and can significantly reduce pain and improve function in patients with knee osteoarthritis. The footwear can enable patients to walk painlessly during real-life activity, thus reacquiring neuromuscular skills and balance.

Full story: 'Walking on balls' therapy from Israel alleviates knee joint pain ...

Product page ... (in Hebrew only)

Poster presentation @ AAOS: Dynamic Wedging: A Novel Method For Treating Knee Osteoarthritis ...

AAOS statement: Dynamic wedging: Effective treatment for knee OA ...

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