S. Mastbergen (Utrecht, NL)

University Medical Center Utrecht Rheumatology & Clinical Immunology
Dr. Simon C. Mastbergen is an associate professor at the department Rheumatology & Clinical Immunology of the University Medical Center Utrecht; The Netherlands. He studied Medical Biology and obtained his MSc in 1998. In 2005 he obtained his PhD which was focused on the role of COX-2 in osteoarthritis. During this period; he interrupted his PhD project to set up; perform and coordinate a large animal study at the department of Rheumatology & Clinical Immunology commissioned by a large English pharmaceutical company (2001-2002). After this study he continued the PhD project which included 1 day per week coordination and carrying out of contract animal and in vitro research; a task still performed today. As such; numerous studies have been performed in cooperation with different (pharmaceutical) companies; both national and international. He has a strong interest in translational rheumatology research with a focus on tissue-regeneration in joint diseases; especially osteoarthritis though not limited to. Central theme of his research is modulation of cartilage; synovium; and bone to prevent and when possible cure joint damage. Within this theme he is involved in several research lines including “causes of development and progression of osteoarthritis”; “DMOADS in treatment of osteoarthritis”; and “Joint distraction in treatment of severe osteoarthritis". More recently; there is a focus on the biochemical interaction between bone and cartilage; the role of pain mediators and their receptors in the osteoarthritic knee joint; and the role of stem cells in intrinsic cartilage repair. Moreover; he initiated development of a whole-joint bio-mechano-reactor; currently at the level of a working prototype; enabling evaluation of many different pathways in the osteoarthritis process. A next step is taken by studying the role of joint homeostasis under influence of joint distraction in intrinsic cartilage repair in the first pilot studies. Within these research lines he pushes for innovation and translation to the clinic.

Presenter Of 1 Presentation

Podium Presentation Osteoarthritis

18.3.10 - The Value of Ankle Joint Distraction in Hemophilic Arthropathy: Three-year Follow-up From the First Prospective Pilot Study

Presentation Topic
Osteoarthritis
Date
14.04.2022
Lecture Time
15:36 - 15:45
Room
Potsdam 1
Session Type
Free Papers
Disclosure
No Significant Commercial Relationship

Abstract

Purpose

Hemophilic ankle arthropathy (HAA) causes major morbidity in (young) patients. Often major surgical interventions like arthrodesis are indicated impacting quality of life severely. Joint distraction has been demonstrated a good joint-preserving alternative in osteoarthritis and retrospective evaluation of three patients with HAA treated with ankle joint distraction (AJD) showed evident clinical and structural improvements. This open prospective study aims to add evidence for the value of AJD in HAA.

Methods and Materials

Patients ≥18 and ≤55 years with severe complaints of HAA and eligalble for arthrodesis were included in this open prospective study. AJD was applied for 8-10 weeks by use of an external frame with 5mm distraction. Data on clinical efficacy and tissue structure changes were gathered before distraction and 6, 12, 24 and 36 months after distraction.

Results

So far eight cases (age 21-53 years) are included. The pain scores decreased significantly at on year which further decreased over time as assessed by the Visual Analogue Score and Ankle Osteoarthritis Score pain score (see figure). Similar, the median AOS function score decreased significantly over time The functional limitations as assessed by the Hemophilia Activities List for simple lower extremities functions improved significantly. The range of motion of the joint was maintained. MRI showed decreased edema and subchondral cysts and thickened cartilage indicating sustainable structural improvements. The main side effect was pin tract infection (6 patients), effectively treated with a short course of antibiotics. There were no adverse bleeding events. In none of the patients the originally indicated arthrodesis was performed.

figure.jpg

Conclusion

This first prospective pilot study showed that AJD in HAA results in decreased pain, improved function, and tissue repair for prolonged time. Though explorative, this joint-preserving therapy may be promising to be an joint preserving surgical intervention.

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