Within 30-40 years, Osteoarthritis will be history

Gino Kerkhoffs by Marieke de Lorijn

Gino Kerkhoffs, Professor and Head of Department of Orthopedics, Amsterdam UMC
Together with a team of sports physicians, radiologists, movement scientists and physiotherapists, Professor Kerkhoffs has set up a center of expertise for the continuous improvement of care for injured (top) athletes. The Academic Center of Evidence based Sports medicine (ACES) stands for a combination of integrated diagnostics, tailor-made treatment and high quality rehabilitation protocols with a longitudinal monitoring of all results to optimize the outcome. The research focusses on primary (surgical) preventive interventions for the treatment of joint disorders of the lower extremity (i.e. the legs), with a focus on ankle cartilage injuries and sports injuries.

Does movement matter?
‘Keeping people in motion brings health gains in all areas. The importance of sports and exercise within society is growing, as sports is becoming an increasingly important aspect of life. The understanding that exercise contributes to the prevention and treatment of numerous diseases is becoming more and more evident. At our department we have a major role in keeping the athletes and the people of the Netherlands healthy, starting from primary prevention of injuries, to mental health, and further on to the prevention of osteoarthritis. Sports can also cause damage to the musculoskeletal system, such as joint wear and tear. If you can eliminate this and are able to position the muscles optimally and prevent cartilage damage, you can create optimal conditions to benefit movement. With better cushioning of a joint, you can prevent cartilage damage or osteoarthritis, even before it really starts. In this way, movement is healthy, without any side effects. Preventing the overload and inflammation of the joint, that’s what it’s all about.’

How can you prevent osteoarthritis?
‘Cartilage research is what we are good at, as is seen in a nice cross-pollination collaboration between Theo Smit (professor of Translational Regenerative Medicine, Amsterdam UMC, location AMC) and a company that deals with body materials, including cartilage substitutes. We hope that cartilage damage can be prevented in the future. This prevention was primarily thought off for top athletes, as well as for people with excess weight, or with such low muscle function that they put too much strain on the joints at an early stage. However, the preventive intervention seems interesting for the whole population in motion. In people who already have some osteoarthritis, we aim to slow down the process so that eventually hip or knee replacements become superfluous. Our aim is that osteoarthritis will be eradicated in 30 to 40 years time. It is therefore a primary, preventative task of great societal impact. After all, osteoarthritis is considered one of the most common diseases of our time. The cartilage of the ankle expands to cartilage of all the other joints. We see a lot of patients with ankle disorders, and the model can easily be transposed. The same goes for the muscles, there are a lot of muscle injuries that limit movement abilities, albeit often to a lesser extent than with disorders of the cartilage’.

How important is the mental aspect in the healing process?
‘I think it is important to consider the whole person in the healing process, certainly also the mental aspects. While longitudinal evidence about any causal relationship is lacking, the suggested relationship between sports career-related concussion and mental health symptoms in former elite athletes warrants the development of support measures for elite athletes transitioning out of sports. Especially for those with a history of concussion. What effect did it have on Dutch international Van Basten when he had to stop playing soccer? If you can’t do what you like best anymore, in all the roles you have, you are limited. He is the former best player of the world. The Drake Football Study The Drake Football Study, successfully initiated by former professional player Vincent Gouttebarge, will measure a range of variables across cardiovascular, musculoskeletal, cognitive and mental health, but will also track players over at least 10 years, thus hopefully filling the gaps in knowledge around the onset and progression of several health conditions associated with a career in football’.

Does research collaboration make a difference?
‘We joined forces even before the official merger between AMC and VUmc back in 2015. The collaboration gives synergy: 1 + 1 = 3. The bundling of research on prevention and treatment of sports injuries from the partners at VUmc and AMC is a highlight in recent times in the Netherlands. This spontaneous collaboration led to an official accreditation as one of ten International Olympic Committee Research Centers for the protection of the Athlete’s health, chaired by professor Evert Verhagen from VUmc and myself. Our team also hosts a number of Team NL’s clinical preferred partner positions with professor of Radiology Mario Maas, cardiologist Harald Jørstad, Simon Goedegebuure and Niels Wijne from Sports medicine and myself in Orthopedics. The Sports medicine research in our center is in great hands with Hans Tol, who was recently appointed as the first professor of Sports Medicine at Amsterdam UMC and leads a talented team of sports medicine researchers. This bundling of expertise provides many more starting points, in addition to what was always there as part of AMS. We are able to work together with several disciplines to address the matter. I’m very keen on this multidisciplinary approach, because it provides the cross links that strengthen the foundation of our research and very important it is more valuable, powerful and above all more fun to work as a team’.