Outcome of osteoarthritis and arthroplasty from patient perspective to molecular profiling.

Meessen, J.M.T.A. (2019)

Doctoral Thesis

With increasing life expectancy, the incidence and burden of osteoarthritis on society increases. Currently, no treatment for end-stage symptomatic osteoarthritis is available and when symptoms become too severe arthroplasty surgery will be performed, replacing the affected joint with a prosthesis. Although replacement surgery of the hip or knee is safe and commonly performed, up to 20% of the patients are unsatisfied with the outcome. The exact reasons for this dissatisfaction are unknown but may vary from the type of surgical procedure itself, expectancy of the outcome surgery to the patient’s preoperative state of overall metabolic health.
We aimed to evaluate some of these aspects related to outcome, from patient perspectives to molecular profiling (e.g. metabolic health). Characteristics of different nature were included: material of prosthesis, physical activity, questionnaires, clinical measures and metabolomics. This holistic approach enables the assessment of more patient specific targets such as advices on treatment modalities. Ultimately, selection of patients, both from a patient’s as well as orthopaedic surgeon’s perspective, will be optimised for the best intervention for the patient. Since osteoarthritis is the major driver for performing arthroplasty, the conclusion of this thesis will spark future studies into OA and its overall effect on disability.

• arthoplasty
• osteoarthritis
• disability
• metabolomics
• patient perspective
• Patient reported outcome measures

• All authors: Meessen, J.M.T.A.
• Supervisor: Nelissen, R.G.H.H.; Slagboom, P.E.
• Committee: Vliet Vlieland, T.P.M.; Gussekloo, J.; Verhaar, J.A.N.; Willems, H.C.
• Qualification: Doctor (dr.)
• Awarding Institution: Leiden University of Medical Center [LUMC], Leiden University
• Date: 2019-09-26