Life with arthroplasty The kneed for an integrative approach

This thesis focuses on knee arthroplasty surgery. After the introduction, the chapters 2-4 focus on (improving) the technical aspects of knee arthroplasty, while the subsequent chapters 5-9 focus on the results of these procedures for patients and society. The thesis then ends with chapter 10, the general discussion. Chapter 1 provides the General Introduction. Chapter 2 describes the development of a 3D CT based imaging technique to measure the transfer accuracy of a virtually planned osteotomy. In Chapter 3 predicted osteotomy planes are evaluated on accuracy when using patientspecific instrumentation (PSI) for total knee arthroplasty. In Chapter 4 we describe a new and now patented method for diagnosing loosening, a complication of Total Knee Arthroplasty (TKP), using CT and inducible displacement. In Chapter 5 our predominant patient group and location is described. It reports on the results of the hospitals in which our studies are performed as well as the survival for the used TKP is given and risk factors for revision. In Chapter 6 a new questionnaire is developed, the Work, Osteoarthritis and jointReplacement Questionnaire (WORQ). The reliability, validity and responsiveness are tested and reported. Chapter 7 reports on the results of a cross-sectional multicentre survey on return to work following TKP. Chapter 8 looks into differences in return to work between TKP and the less invasive Unicompartmental Knee Arthroplasty (UKP). In Chapter 9 it is assessed which patients do not return to work after TKP. Chapter 10 provides the General discussion.