PhD defence N.S. (Noortje) Riedstra

Brief summary:

Osteoarthritis is a leading cause of pain, disability, and decreased quality of life worldwide (1). Not only does this pose a significant burden on individuals suffering from disease, osteoarthritis also represents a financial burden for society (2). A study that estimated the lifetime risk of developing symptomatic hip osteoarthritis, found that one in four individuals develops this condition by the age of 85 (3). Presently there is no cure of hip osteoarthritis in the form of disease modifying drugs or preventative surgical interventions, which makes total hip replacement the only treatment option for end-stage disease. It is therefore essential to study early treatment options and preventative strategies for hip osteoarthritis. In order to advance research, we must identify modifiable risk factors to target. Hip morphology has been recognized as an important risk factor, as an altered hip shape changes the biomechanical forces acting on the joint, which leads to soft tissue and ultimately cartilage damage associated with hip osteoarthritis. In order to investigate the associations between hip morphology and hip osteoarthritis, both the predictor and outcome must be defined clearly in epidemiological studies. Here I provide a summary of the chapters covering the two aims of this thesis. The first aim was to validate an automated method to quantify hip morphology. We describe the World COACH consortium, a collection of all worldwide available cohorts with prospective hip imaging available, we validate an automated method to study hip morphology in the consortium, and investigate the additional value of false profile radiographs compared to anteroposterior radiographs alone in the diagnosis of developmental dysplasia of the hip. The second aim was to study associations between hip morphology and hip osteoarthritis. We specifically researched acetabular dysplasia (undercoverage of the femoral head by the acetabulum) and pincer morphology (overcoverage of the femoral head by the acetabulum).