Inclusion criteria:	Patients who met the surgical threshold for Orthopaedic referral (Oxford Knee Score<19) AND radiological evidence of moderate /severe osteoarthritis
	Radiological features of severe disease are present. Demonstrates disease within all three compartments of the knee (tri-compartmental) or localised to one compartment plus patello-femoral disease (bi-compartmental).
	The patient complains of intense or severe symptomatology
Exclusion criteria	Pediatrics (17 yrs and below)
	Patients suffering from uncontrolled inflammatory conditions (e.g. Rheumatoid Arthritis)
	Patients who received a visco-supplementation/corticosteroid injection 3 months prior to the entry point of the Apos pathway (although exceptions could apply, e.g. if the patient would benefit from both interventions – this would need specific individual prior approval before)
	Patients suffering from avascular necrosis of the knee. Patients suffering from neuropathic arthropathy (Charcot’s joint)
	Patients exhibiting a lack of physical or mental ability to perform or comply with the treatment
	Patients with a history of pathological osteoporotic fracture
	Patients whose main complaint is another lower limb joint other than the knee.
	Patients who are unsafe to participate in the treatment and fail to pass the balance protocol at initial consultation (balance screening tool)