Gewoon artrose

Gewoon artrose. Is artrose inderdaad zo gewoon? Ja, helaas wel. Iedereen weet wel een familielid of bekende op te noemen die geopereerd is voor artrose, en als u in uw omgeving navraagt, blijken er nog veel meer mensen last van te hebben. Artrose, in de volksmond gewrichtslijtage, is een heel gewone aandoening die veel voorkomt, vooral op oudere leeftijd, die niet levensbedreigend is. “Ach, het is de ouderdom, ik moet er maar mee leren leven” zal u niet onbekend in de oren klinken. Gewoon, een hinderlijke aandoening. Maar ondanks dat artrose, èn de last die mensen daarvan hebben, zoveel voorkomt, hebben we op heel veel gewone vragen over artrose nog geen antwoord. Vandaag aanvaard ik mijn benoeming op een bijzondere leerstoel voor deze zeer gewone aandoening, de eerste in Nederland. Ik ga u de komende drie kwartier laten zien waarom deze nieuwe leerstoel noodzakelijk is, èn wat u van mij en mijn team aan inspanningen mag verwachten. Rede, uitgesproken ter gelegenheid van het aanvaarden van het ambt van bijzonder hoogleraar met als leeropdracht Artrose en gerelateerde aandoeningen, aan het Erasmus MC, faculteit van de Erasmus Universiteit Rotterdam op 16 december 201

Osteoarthritis subpopulations and implications for clinical trial design

Treatment guidelines for osteoarthritis have stressed the need for research on clinical predictors of response to different treatments. However, identifying such clinical predictors of response is less easy than it seems, and there is not a given classification of osteoarthritis subpopulations. This review article highlights the key methodical issues when analyzing and designing clinical studies to detect important subgroups with respect to treatment effect. In addition, we discuss the main osteoarthritis subpopulations and give examples of how specific treatment effects in these subpopulations have been assessed

Hip Pain in general Practice: exploiration and classification

Musculoskeletal diseases are the second most costly group of disorders in primary care in the Netheriands. Of the musculoskeletal disorders, hip problems occur most frequently in the aged. Therefore, in the coming decades, prevalence of hip disorders, of which an important part is attributed to osteoarthritis of the hip,' is expected to increase due to ageing of the population. The report 'Public Health Status and Forecasts 1997' predicts that by the year 2015 the incidence of osteoarthritis will have increased 36% compared to the current incidence.' Besides generating high costs, hip disorders have a major impact on the life of individuals, not only due to the presence of pain, but also because of tl,e adverse effects on the mobility and daily activities of the elderly. A recent Dutch study in the open population aged 55 years and over and living independently revealed that 16.6% of the women and 8.3% of the men reported hip pain.' In the Netherlands, the general practitioner is the fIrst physician who is consulted and therefore plays an important role in the management of these disorders. Optimal management, however, requires accurate diagnosis. The Dutch College of General Practitioners has published national gnidelines for the diagnosis, treatment and referral of many disorders in general practice.' For hip disorders, however, no such guidelines are yet available. International (ICPC) codes for several hip disorders in general practice have been introduced', but these lack clear guidelines as to what clinical criteria constitute these conditions. The possibility in the ICPC to code a hip problem as 'unspecifIed' is eagerly accepted by general practitioners; at least one tlilld of tl,e patients with hip complaints receives no specifIc diagnosis

Prevalence and radiological definitions of acetabular dysplasia after the age of 2 years:a systematic review

Acetabular dysplasia is one of the most common causes of early hip osteoarthritis and hip replacement surgery. Recent literature suggests that acetabular dysplasia does not always originate at infancy, but can also develop later during childhood. This systematic review aims to appraise the literature on prevalence numbers of acetabular dysplasia in children after the age of 2 years. A systematic search was performed in several scientific databases. Publications were considered eligible for inclusion if they presented prevalence numbers on acetabular dysplasia in a general population of healthy children aged 2–18 years with description of the radiological examination. Quality assessment was done using the Newcastle-Ottawa score. Acetabular dysplasia was defined mild when: the center-edge angle of Wiberg (CEA-W) measured 15–20°, the CEA-W ranged between -1 to -2SD for age, or based on the acetabular index using thresholds from the Tönnis table. Severe dysplasia was defined by a CEA-W < 15°, <-2SD for age, or acetabular index according to Tönnis. Of the 1837 screened articles, four were included for review. Depending on radiological measurement, age and reference values used, prevalence numbers for mild acetabular dysplasia vary from 13.4 to 25.6% and for severe acetabular dysplasia from 2.2 to 10.9%. Limited literature is available on prevalence of acetabular dysplasia in children after the age of 2 years. Prevalence numbers suggest that acetabular dysplasia is not only a condition in infants but also highly prevalent later in childhood

Obesity and hip osteoarthritis [1]

To the Editor:We read with interest the editorial by Gelber that appeared in the February issue of The American Journal of Medicine. The author presents a good overview of the effects and known risk factors of osteoarthritis, discussing the influence of obesity on hip osteoarthritis. We would like to add to this by reporting a finding from our recent review of the topic.<br/

Obesity and hip osteoarthritis [1]

To the Editor:We read with interest the editorial by Gelber that appeared in the February issue of The American Journal of Medicine. The author presents a good overview of the effects and known risk factors of osteoarthritis, discussing the influence of obesity on hip osteoarthritis. We would like to add to this by reporting a finding from our recent review of the topic.<br/