F. Lafeber (Utrecht, NL)

University Medical Centre Utrecht Rheumatology and Clinical Immunology
Floris Lafeber (1961) is professor of ‘Experimental Rheumatology at the University Medical Centre Utrecht (UMC Utrecht; NL since 2009); manager of research of the dept. of Rheumatology & Clinical Immunology and head of its research laboratory (since 1992); manager research of the devision of Internal Medicine & Dermatology (since Feb 2016); and cofounder of ArthroSave BV. He studied Biology at the Univ. of Nijmegen (NL; graduated Nov 1984); did his PhD at this Univ. in collaboration with the Univ. of Leiden (NL); with a visit of three months at the dept of Physiology; Univ. of Ottawa (Canada) (graduated April 1988). He is scientifically active in the field of ‘Regenerative Medicine and ‘Immunology. Currently; his main interest is in novel treatments (joint distraction to treat end-stage knee osteoarthritis; and an IL4-IL10 fusion protein (synerkine) to control cartilage damage; inflammation; and pain in osteoarthritis (OA); haemophilic arthropathy (HA); and rheumatoid arthritis (RA)); diagnostic tools for automated analyses of radiographic joint damage and inflammation in OA; HA and RA; as well as unique animal in vivo models of osteoarthritis (rat and canine Groove model); which have all been developed over the past years. Floris Lafeber is (co-)author of over 300 peer-reviewed papers (H-index 48); of which more than half in the top 10% of the field; supervised 30 PhD with an additional 15 scheduled. He has several patents in this field.

Presenter Of 1 Presentation

 ICRS 2022 - Online Programme
Podium Presentation Osteoarthritis

18.3.7 - Grip on Knee Osteoarthritis: Joint Distraction Versus Arthroplasty (GODIVA) - A Large Randomized Controlled Multicenter Trial

Presentation Topic
Osteoarthritis
Date
14.04.2022
Lecture Time
15:09 - 15:18
Room
Potsdam 1
Session Name
18.3 - EOA I - Recent Basic & Clinical Advances
Session Type
Free Papers
Speaker
Authors
Disclosure
No Significant Commercial Relationship

Abstract

Purpose

For relatively young (≤65 year) patients with end-stage knee osteoarthritis (OA) with persistent, pain, insufficiently responding to conservative management, knee arthroplasty (KA) is a frequently applied treatment. A primary KA in this age group often requires revision surgery later in life. Revision surgery is complex, costly, and accompanied by multiple complications. Knee joint distraction (KJD) is a joint preserving treatment that delays the need for primary KA. KJD has proven to be effective in reducing pain and stiffness and improving function in studies (Jansen M, et al. Cartilage 2020). In a pilot study KJD was slightly less effective than KA, although not statistically significant (Jansen M, et al. Cartilage 2021). Therefore, this study aims to determine whether KJD is non-inferior on patient reported outcome as compared to KA for these patients.

Methods and Materials

Pragmatic, open, randomized, multi-centre (fig), non-inferiority trial with 2 year follow-up. 1,200 knee OA patients ≤65 year indicated for a KA are randomized (1:1) to KJD or KA. KA and KJD are indicated and executed in regular practice in line with national guidelines and recommendations for practice, respectively. KJD treatment uses an external fixation frame, distracting the two bony ends of the knee joint at 5mm according to prescribed procedures for six weeks (fig), with full weight-bearing allowed and encouraged. Rehabilitation is according to regular practice. Primary and secondary outcomes are pain, stiffness, physical functioning (WOMAC), quality of life (EQ-5D), adverse events and cost-effectiveness. All over 24 months.

figure 1.jpg

Results

As discussed and endorsed with all stakeholders, including patient and professional associations, this study needs to demonstrate non-inferiority of KJD compared to KA with a non-inferiority limit of 15 points on the WOMAC total score.

Conclusion

This study will determine the place of knee distraction in the treatment of relatively young end-stage knee OA patients.

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Moderator Of 1 Session

 ICRS 2022 - Online Programme
Bellevue Free Papers

10.3 - OA & Cartilage Repair Outcomes Imaging

Session Type
Free Papers
Date
13.04.2022
Time
13:00 - 14:40
Room
Bellevue
Moderators
CME Evaluation (becomes available 5 minutes after the end of the session)
Session Evaluation