PhD defence R.M. (Robbert) Wouters
- Prof.dr. H.J. Stam
- Dr. R.W. Selles
- Dr. H.P. Slijper
On Wednesday 5 February 2020, R.M. Wouters will defend his PhD dissertation, entitled: ‘No Rules of Thumb: Outcome Measurement and Treatment for Thumb Base Osteoarthritis’.
This thesis, consisting of 3 parts, describes the treatment and outcome measurements for thumb base (CMC-1) osteoarthritis. Until recently, the evidence for non-operative treatment of CMC-1 osteoarthritis and instability was lacking, but in part 1 of this thesis, we found that non-operative treatment of CMC-1 osteoarthritis and instability was very successful, that only 14-15% of these patients still underwent surgery, and that exercise therapy is of great added value and should be part of this treatment. Furthermore, we found that patients scheduled for surgery had more symptoms, worse psychological profile, and higher treatment expectations compared to their non-surgical counterparts. In part 2 of this thesis, we found that early active rehabilitation (consisting of short immobilization and early initiation of exercises) does not lead to worse outcomes or more complications. This indicates that short immobilization is safe and can be recommended, since it may have many benefits for the patient. Furthermore, we found that psychological factors, female sex, and opioid usage predict acute postoperative pain, beyond type of surgery, sociodemographics, or clinical characteristics. In part 3 we describe the development, design, and implementation of the "Hand and Wrist Study Cohort" in our treatment centers for hand and wrist care. In this cohort, over 85.000 measurement tracks have now been allocated to more than 52.000 patients. In addition, we describe the principles of developing a standard set for outcome measurement in patients with hand and wrist conditions, developed by the International Consortium for Health Outcome Measurement (ICHOM).
The public defence will take place at the Prof. Andries Queridoroom, 3rd floor Education Center, Erasmus MC. The ceremony will begin exactly at 13.30 hrs. 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.