PhD defence M.L.A. (Marieke) Landsmeer

Knee osteoarthritis is the most frequent form of joint disease. The prevalence increases sharply after middle age, especially in women. There is no cure for knee osteoarthritis. This thesis focuses on prevention and prediction of knee osteoarthritis among 407 women aged 50-60 years with a BMI of 27 or higher and without knee osteoarthritis at the start of the study. The PROOF study was, and still is, the first RCT in the prevention of knee OA. It studied the preventive effects of a lifestyle program and of oral glucosamine. In this thesis the effects on different structural OA features on MRI were evaluated. It showed that there was less progression of meniscus extrusion in the lifestyle intervention group after 2.5 years than in the control group: 13 versus 21 percent. Meniscal damage plays an important role in the development of osteoarthritis. Also, the women who had gained weight were 2.5 times more likely to have progression of synovial inflammation than women who had maintained the same weight over 2.5 years. This inflammation seems unfavorable to the knee joint. Furthermore, women with a healthy weight at age 40 had fewer abnormalities on MRI at the start of the study. Glucosamine did not have any preventive effect. Predicting the development of knee osteoarthritis using anamnesis and physical examination is currently not applicable in practice, although knee stiffness and knee complaints when climbing stairs deserve further investigation. Continuous efforts will remain necessary for the prevention and prediction of this highly disabling disease.

The public defence will take place at the Prof. Andries Queridoroom, 3rd floor Education Center, Erasmus MC. The ceremony will begin exactly at 13.00 PM. In light of the solemn nature of the ceremony, we recommend that you do not take children under the age of 6 to the first part of the ceremony.