PhD defence Ralph Maria Jeuken

Keywords: Cartilage, Joint Preservation, Knee

"Knee joint preservation throughout life"

Maintaining healthy knees is crucial for mobility and quality of life. This thesis explores how to preserve the knee joint, especially in middle-aged patients who often fall between regenerative and replacement options. It presents a modified surgical technique for reattaching cartilage fragments in young patients, showing excellent healing and full return to sports. A review of existing treatments found that microfracture procedures perform poorly in older patients, while bone-based methods such as osteochondral grafts and focal knee resurfacing implants (FKRIs) show better long-term results. A national survey revealed that many Dutch surgeons still use outdated treatments, highlighting the need for better education and guideline adherence. Finally, the thesis introduces a new implant made from polycarbonate-urethane (PCU) and zirconium oxide, offering a durable, MRI-compatible alternative to metal implants. Overall, it emphasizes smarter, age-specific strategies to delay or prevent knee replacement surgery.

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