Osteoarthritis (OA) is a common disease of the musculoskeletal system. In the Netherlands approximately 1.2 million people suffer from OA. OA can arise in all synovial joints, but knee, hand and hip are most often affected. The incidence rate of OA is growing after the age of 50 years.4 Besides, prevalence of OA is increasing because of aging of the population and gaining prevalence of obesity. Symptomatic knee OA is most prevalent, almost twice compared to hip OA. Based on registrations in Dutch health care, the prevalence for symptomatic knee OA is estimated to be 44 per 1000 women and 28 per 1000 men. OA is generally regarded as a degenerative disease of the whole joint with involvement of all tissues: cartilage, (subchondral) bone, synovial fluid, ligaments, and surrounding muscles. Clinical signs of knee OA are joint pain, stiffness and limited joint function. These symptoms limit daily activities and influence quality of life of patients negatively. Knee OA is a multifactorial disease, and well-known risk factors are obesity, female sex, older age and previous knee injury. The meta-analysis of Blagojevic et al. showed that previous knee injury the strongest risk factor was for onset of knee OA. In the current thesis the main focus is which (degenerative) changes develop after a common knee injury: anterior cruciate ligament (ACL) rupture. Curative treatment options do not exist for OA. Up to now no disease modifying OA drugs has proven to be effective. Conservative treatment options for knee OA, such as exercise, weight reduction in overweight or obese patients, anti-inflammatory drugs and intra-articular injections mainly aim symptomatic relief. In addition, if relief of symptoms fails after conservative treatment, osteotomy, unicompartmental arthroplasty and, for end-stage disease, total knee arthroplasty could be considered. Knee OA is one of the leading causes for global disability with high burden concerning both individual and socioeconomic consequences. The burden of OA could be divided into direct costs (medical consumption), indirect costs (reduced employment, reduced productivity, absenteeism) and intangible costs (pain, reduced social participation, activity limitation, decreased quality of live).

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S.M. Bierma-Zeinstra (Sita)
The publication of this thesis was financially supported by: Nederlandse Orthopaedische Vereniging, Nederlandse Vereniging voor Arthroscopie, Reumafonds, Vereniging voor Sportgeneeskunde, Anna Fonds te Leiden, Erasmus MC afdeling orthopaedie, MC Haaglanden, Bauerfeind, Biomet, DC klinieken, KBC Haaglanden, Medicort, Smith and Nephew, Spomed fysiotherapie.
Erasmus University Rotterdam
hdl.handle.net/1765/77820
Erasmus MC: University Medical Center Rotterdam

van Meer, B. (2015, March 18). Identification of Early Degenerative Changes in the Knee after Anterior Cruciate Ligament Rupture. Retrieved from http://hdl.handle.net/1765/77820