Dr. Pieter Emans orthopaedic surgeon More than a million people in the Netherlands suffer from osteoarthritis, i.e. damage to the cartilage in one or more joints. The main symptom is pain - and that is exactly what brings patients through the doors of our outpatient clinic. If we are unable to adequately control this pain through medication, we have no option but to consider a prosthesis. But a new knee does not last forever: currently, we are able to replace a knee three times on average, resulting in a total lifespan of around thirty years. Consequently, we are looking to postpone the moment at which we consider joint replacement surgery for as long as possible. But if you had your first artificial knee at fifty, you will be struggling again by the age of eighty. To innovate in healthcare, we have to assess the care we currently provide; an exercise in which cooperation between hospitals, private companies and scientists studying fundamental physical processes is indispensable. Together with DSM and Utrecht University, for example, we are studying an anti-inflammatory injection that releases its active substance into the body in small doses over a longer period of time. In terms of innovation, we are also working with the experimental orthopaedics lab in the hospital and the Maastricht-based research institutes M4I and MERLIN. When it comes to assessment, we are working with rheumatologists, physiotherapists, movement scientists and, occasionally, general practitioners. By peer-to-peer knowledge sharing we can improve the care we provide. That is our main task as a university hospital: assess innovations through these types of networks to ensure they can be implemented in practice, with the ultimate aim of ensuring people can stay mobile for longer. Our eventual aim is to try to prevent osteoarthritis from occurring. We are finding out more and more about its causes: any injury to your cruciate ligaments or meniscus presents a risk factor for future osteoarthritis, as does obesity. On a nationwide basis, we are working on a risk profile that will enable us to proactively warn people who are at higher risk of developing the disease. We cannot check everybody’s knees every year - that would be far too expensive - but we should consider something along those lines for certain high-risk groups. On the job
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