Many Dutch people do not meet the Health Council’s guideline of 2.5 hours of moderate or intensive exercise every week.Image Jakob van Vliet
“Take the stairs, it’s healthier.” There are blue stickers on the floor near the elevators in the Erasmus MC in Rotterdam, encouraging patients and the hospital’s 16,000 employees to walk. Behind those stickers is Denise Eygendaal (54), the first female professor of orthopedic surgery in the Netherlands and a fervent campaigner against lack of exercise.
“Exercise is not only important for people, but also for the environment,” says Eygendaal. “If we could virtually shut down some of the nearly ninety lifts, that would be fantastic. Lack of exercise causes approximately 2.7 billion euros in treatment costs every year.”
Dutch people sit for an average of 9 hours and 6 minutes every day, the National Institute for Public Health and the Environment (RIVM) calculated. For Eygendaal, who is also the head of the orthopedics and sports medicine department, this is reason enough to speak of a ‘sitting epidemic’. Sitting a lot is associated with a higher risk of cardiovascular disease, type 2 diabetes and premature death. “Every year, six thousand people die in the Netherlands from conditions resulting from too much sitting and too little exercise,” says Eygendaal.
In November, the RIVM released current figures on the reduced mobility of Dutch people: only 44 percent met the Health Council’s guideline of 2.5 hours of moderate or intensive exercise every week. That was 49 percent three years ago (before corona).
Climbing stairs, walking or cycling can be enough
Eygendaal, who has played badminton at national level, emphasizes that people should not exercise intensively more often. Climbing stairs, walking or cycling can also be good for you.
“There is a nice study on people who are slightly overweight,” she says. “Four groups were compared with each other. One group did nothing; their condition slowly deteriorated. The second group had to go to the gym and exercise moderately. The third group had to move vigorously there. And group four were allowed to cycle to work in a relaxed manner. Six months later it turned out that the three groups that exercised had the same increase in fitness.”
If there is more exercise, fewer people will need surgery, says Eygendaal. “Research into, for example, hip and knee osteoarthritis shows that people have fewer complaints by exercising,” says the professor. “On the other hand, osteoarthritis can also occur with too much exercise or being overweight. Or the condition is genetically determined, so there isn’t much you can do about that. But everyone has their own responsibility and as a specialist you can address this.”
Innovation
Meanwhile, a lot of innovation is taking place in orthopedic surgery in the Netherlands (see box). “If you see how efficiently the work is done, that a hip or knee operation only takes two days of treatment in the hospital, then that is an incredible achievement and a huge difference from thirty years ago,” says Eygendaal. “We hope that through prevention, by keeping the Netherlands moving, the number of hip and knee operations will decrease.”
The operation itself is quite technical, she says. “You have to screw bones together, saw them, cement prosthetics, know something about biomechanics. You’re kind of like a construction worker. If you don’t know anything about drilling and sawing, it will be difficult. But if it is, you have a fantastic profession.”
Professor of orthopedic surgery Denise Eygendaal (54). Image Erasmus MC
Innovation in orthopedic surgery
Approximately 35,000 hips and 25,000 knees are fitted in the Netherlands every year, says Eygendaal. “They don’t last forever; at some point they become loose. Sometimes there is a bacteria in it, then you get bone defects. With the help of 3D images, we can now determine in advance how big the defect is and develop an implant for it.”
“For cancer metastases in bones, we can use 3D planning to ensure that patients keep moving during complex operations – such as in the spine. The same goes for forearms and elbows. If an arm is crooked, we can use CT scans to virtually mirror the healthy side and use this to make a good reconstruction.”
Eygendaal hopes to achieve success in two areas in particular: osteoarthritis and osteochondritis dissecans (OCD) in the elbow. She conducts research into both in collaboration with TU Delft and Erasmus University.
“Osteoarthritis is the most important limiting motor disorder for people who cannot move,” she says about the first condition, which is expected to be the most common chronic disease in the Netherlands by 2040. “I hope to be able to make progress in this area within ten years with early diagnosis, early treatment and also prevention.”
With OCD, the bone just below the cartilage becomes weakened, which can damage blood vessels to the bone. If blood does not flow through the bone, part of the bone may die. “This is a condition that we mainly see in young tennis players, gymnasts and athletes. OCD can mean that they can no longer exercise and have a high risk of osteoarthritis.”
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2023-12-26 14:35:46
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