Biomechanical Footwear as a Non-invasive Alternative and Supplement to Total Knee Replacement

Inclusion Criteria: * Men or non-pregnant women * Between ages 45 and 80, inclusive * ACR clinical criteria for OA of the knee * Symptomatic uni- or bilateral OA of the knee for at least six months * Radiological criteria: X-rays showing tibiofemoral knee osteoarthritis defined as at least Kellgren and Lawrence Grade 2 * At least a moderate NPRS pain score at baseline (≥5) * Score of 1-3 based on the American Society of Anesthesiologists Physical Status Classification System * Willing and able to read, comprehend, and sign the study informed consent form in English prior to study specific procedure Exclusion Criteria: * Body Mass Index (BMI) \> 40 * History of an inflammatory rheumatic disease * Non-knee musculoskeletal pain that is more severe than the knee pain * Corticosteroids injections in the knees in the previous 6 weeks * Previous major surgery to the knee such as osteotomy, hemiprosthesis, unilateral total joint replacement excluding knee arthroscopy \> 6 months * Patients with Geisinger Health Plan insurance for whom Apos is a covered treatment * Patients with a recent history (\<3 months) of a mental health condition, such as depression or anxiety * Problems with balance (\>2 unexplained falls within the last 12 months; experiencing regular dizziness that has caused a trip or fall; using a walking aid to get around such as a rollator, cane, walker)