Prognostic factors for cartilage degeneration after meniscectomy and cruciate ligament injuries
A prospective observational cohort study during 10 years
- Prof. Rob G.H.H. Nelissen MD, PhD
- Prof. J.L. Bloem, PhD (Radiology)
- Prof Ian Watt, MD, PhD (Radiology)
- A. van Erkel, MD, PhD, (Radiology)
- I Meulenbelt, PhD (Molecular Genetics)
- M Kloppenburg, MD, PhD (Rheumatology)
- B.C. Stoel, PhD (Image processing)
- Prof. H. Reiber, PhD (Image processing)
Kasper Huetink, MD
- MRI, Radiographs
1/5/2006 - 1/5/2009
Dutch Arthritis Association (in dutch: Reumafonds)
Large prospective studies have confirmed knee trauma to be a significant risk factor for knee osteoarthritis (OA). This fact is stressed by the fact that joint complaints account for 51% of all new cases of occupational illnesses in the Netherlands and diseases of the knee are third in importance for workman's’ compensation. On a yearly basis orthopaedic surgeons in the Netherlands perform about 35.000 meniscectomies of the knee. Although age is the strongest predictor of the development of radiographic osteoarthritis (ROA), genetic and mechanical factors (e.g. meniscus or ligament injury) have a considerable effect on progression of OA. In general a 6-fold increased relative risk for the development of ROA exists after total meniscectomy. Preventive measures even after a partial meniscectomy may prove to be cost effective if distinct, high risk, groups of patients can be identified.
In 1997 a Grant from the Dutch Insurance Council (D94-071) included 850 patients with knee complaints (mean age 31 years) in a study. All patients had physical, radiological examination (X-ray and MRI of the knee). According to criteria of the Dutch Orthopaedic Society in 510 patients arthroscopies were performed (all video- taped). At arthroscopy medial (211), lateral (115) meniscectomies were performed and 72 cruciate ligaments were present.
Goal of the study is to evaluate risk factors for development of ROA of the knee at 8-9 years based on findings during arthroscopy and general risk factors (obesity, family, etc) in order to identify high risk groups of patients for OA after a knee injury. The latter is the basis for new studies on preventive measures for developing OA.