I have arthritis in both knees and my orthopedic convinced me to run in Hokas, thinking that this would alleviate the pain while running. Having purchased two pairs of Hokas, a new ($300) pair of custom orthotics and undergoing five Synvec injections, I'm convinced that none of these really help with aging, arthritic knees. I still like running in Hokas and feel they will be around far longer than Viabrams, but I don't see these shoes as helping much with alleviating patellar arthritis pain. I do feel Treadmill running is far easier on the joints, now!