This thesis has provided more knowledge on the disease course and its determinants of outcome in hand osteoarthritis. The role of joint-specific factors and coping styles on disability, the... Show moreThis thesis has provided more knowledge on the disease course and its determinants of outcome in hand osteoarthritis. The role of joint-specific factors and coping styles on disability, the prevelance of aesthetic dissatisfaction, its impact on daily life and their determinants were evaluated. Additionally, the association between MR Imaging features with hand pain and the association of MR Imaging features with radiographic progression were investigated. Another part of the thesis focused on the association between osteoarthritis and mortality. Show less
Total hip-and total knee arthroplasties (THA/TKA) are effective treatments for end-stage hip/knee osteoarthritis, leading to satisfactory improvement of pain/function in 80-90% of the patients... Show moreTotal hip-and total knee arthroplasties (THA/TKA) are effective treatments for end-stage hip/knee osteoarthritis, leading to satisfactory improvement of pain/function in 80-90% of the patients within 12-months after surgery. Overall, knowledge regarding clinical outcomes reflecting the process of recovery in patients undergoing THA/TKA over a prolonged period is scarce. First, this thesis addressed the successfull feasibility of collecting a comprehensive set of outcomes relevant for the process of recovery. Second, it was found that the decrease in pain/improvement in function after 1 -year in THA-patients, but not in TKA-patients, was positively associated with more preoperative radiographic severity of OA. Thirdly, most patients’ preoperative expectations of outcomes of THA/TKA regarding functioning were met, unfortunately more frequently not in TKA-patients. Finally, 90%/52% of THA/TKA-patients return after surgery after 12-weeks on average. However, despite high return-to-work rates, a considerable proportion of the patients who return-to-work, worked less hours than preoperatively. Concluding, although overall favourable outcomes were seen, this thesis identified a number of areas for improvement: better identification of subgroups with a likely perceived unsuccessful outcome or recovery process, if not preoperatively then early after surgery. Early identification and subsequent interventions may change the course of recovery of THA/TKA for such patients, leading to added value in this subgroup. Show less
In dit proefschrift worden de moleculaire mechanismen behandeld die onderliggend zijn aan artrose. Specifiek wordt genoomwijd onderzocht welke genen anders tot expressie komen in aangedaan... Show moreIn dit proefschrift worden de moleculaire mechanismen behandeld die onderliggend zijn aan artrose. Specifiek wordt genoomwijd onderzocht welke genen anders tot expressie komen in aangedaan vergeleken met gezond kraakbeen van artrose patienten. Dit in de context van epigenetische regulatie van gen expressie, specifiek door DNA methylatie in het licht van de lokale genetische context in de vorm van puntmutaties. Show less