Academic Center for Bone & Joint

The aim of this ACE is to be a knowledge and expertise center in the field of bone and joints in the clinical and research setting.
This includes performing state of the art patient care, research and teaching on these topics while aiming to increase the knowledge on disorders of bone and joints and their interaction for building and maintaining optimal function of our musculoskeletal system.

Academic Center of Excellence

Research Activities

Almost all research in this ACE is multidisciplinary and involves all four "dimensions" of research (fundamental, translational, clinical, epidemiological).

By direct access to the open population, patients, and patient material, and by genetic research, functional molecular cell biological and animal based research including translational studies on tissue repair, the ACE aims to understand pathophysiology of diseases of bone and joints and their interaction as well as to develop novel diagnostics and therapeutics. Our plan is to integrate and extend these programs with the aim to form a chain from the patient to the lab and the population-based research back to the patient. We already have a close collaboration with local hospitals and GP practices for our clinical research network.

We have firmly established international research collaborations in the UK, USA, Sweden, Ireland, Finland, Australia, and Austria. Further we are coordinating several EU funded research consortia (GEFOS, GENOMOS, RUBICON, TargetCare, CarBon), are collaborators in others (CHARGE,GIANT, JIGSAW, D-BOARD), and are coordinating or involved in intercountry funded collaborations (OA TRIAL BANK, SMART STEP, CARTSTAFF). We are developing international research programs on bone associated cancer, molecular action of vitamin D, development and validation of novel OA imaging, and statins for low grade joint inflammation.

Type of


Research: We have firmly established international research collaborations in the UK, USA, Sweden, Ireland, Finland, Australia, and Austria. Further we are coordinating several EU funded research consortia (GEFOS, GENOMOS, RUBICON, TargetCare, CarBon), are collaborators in others (CHARGE,GIANT, JIGSAW, D-BOARD), and are coordinating or involved in intercountry funded collaborations (OA TRIAL BANK, SMART STEP, CARTSTAFF). We are developing international research programs on bone associated cancer, molecular action of vitamin D, development and validation of novel OA imaging, and statins for low grade joint inflammation.

Research: We have collaborations with the ACE SCORE, Gender specific translational research, healthy ageing

Patient care: We have firm clinical collaborations beteen the disciplines within the ACE in the Bone Center Rotterdam



The contribution of the ACE Bone & Joint to the educational programs of Erasmus MC takes place on different levels:

BA level: Medical curriculum: Musculoskeletal imaging, Calcium and Bone metabolism and diseases, VO bone pathology; Clinical technology curriculum: Musculoskeletal development and pathology, Calcium and Bone metabolism and disease, Bone growth and remodelling, Osteoarthritis, Imaging; Keuze-onderwijs Balans-Disbalans, Bewegingsapparaat; Minor in these topics, i.e. Minor Orthopaedische sporttraumatologie.

MSC level: Medical curriculum: Musculoskeletal radiology, calcium and bone metabolism, common and rare endocrine bone diseases; MSC thesis: supervision

PhD level: Molmed: endocrinology, osteoporosis, osteoarthritis Postdoctoral level: teaching for residents, Internal Medicine, endocrinology, rheumatology, traumatology, orthopaedics, Internists, Endocrinologists, Gastroenterologists, Orthopaedic and Traumatology Surgeons, Radiologists, and GPs.

Postgraduate level: Postgraduate program for GPs with special interest in Musculoskeletal Diseases; Local GPs: endocrinologists; Gastroenterologists, Orthopaedic and Traumatology Surgeons, Radiologists, International post doc fellows: 4 (Korea, Ireland, Italy, India) International PhD students: 9 (Switzerland, Ireland, USA, Germany, Turkey, Thailand, Spain, China, Costa Rica)


Care Activities

The ACE participates in the Erasmus MC program "Value based health care". We aim that 80% of the care within the ACE is labeled as academic according to the ROBIJN model.

Outcome measures are defined together with patients, measured for each patient and the results will be used for improvement of the individual care. Within this ACE the "Bone Center Rotterdam" was set up in 2013 in order to harmonize and improve care of patients with common and rare disorders in calcium and bone disorders and was recognized in 2015 as expert center on Primary Bone Dysplasia's by the NFU in 2015. Clinical pathways are defined and multidisciplinary teams discuss individual patient care.

There is a collaboration with LUMC and VUMC in a "Dutch Bone Center" The ACE also participates actively in the EU-based ERN application for rare bone diseases and Rare Endocrine diseases. Pre- and post joint prosthesis patient related outcomes are recorded for a national registry (LROI), and novel and high technology alternatives for joint prosthesis in early OA are developed, trained and introduced.

The orthopedic care within this ACE is also featured by surgery of complex stress fractures in case of osteoporosis medication, and post prosthesis revision surgery in case of extensive bone loss. Radiology delivers within this ACE state of the art imaging along with a high level of subspecialized expertise in all aspects of musculoskeletal disease including rare and complex disorders. Plastic surgery coordinates the expert care for craniosynostosis. Within GP practices we run implementation programs for high quality osteoarthritis care, care for neck/shoulder pain and traumatic knee pain. Research outcomes are implemented in clinical care when relevant.

In 2017 we also started the multidisciplinary center for groin injuuries.

Societal Relevance to Research, Education and Patient Care

The ACE Bone & Joint majorly contributes to public and population health and/or medicine.
Some of these examples are given below:

National guidelines: NHG guidelines "knee complaints", VKB injury (NOV), arthroscopic interventions in the knee (NOV), osteoporosis & fracture prevention (CBO), National Guideline Treatment and Care for Craniosynostosis.

International guidelines: ESHRE Guideline: management of women with premature ovarian insufficiency;OARSI guidelines for the non-surgical management of knee osteoarthritis (2014); EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying anti-rheumatic drugs: 2013 update; EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis (2010); OARSI guideline for managment of knee and hip OA (2019); NOV guideline for diagnosis and management of knee and hip osteoarthritis (2018). Reference Network for rare bone diseases (BOND) (2017)

Guidelines in development: European guideline committee on Paget's diseases; Hypophosphatasia and Bone Disease in Cancer Treatment; European guideline committee on pseudohypoparathyroidism; National multidisciplinary guideline on the diagnosis and treatment of osteoarthritis, and the revised guideline for VKB injury. (NOV). Dutch multidisciplinary guideline 'Achilles Tendinopathy' on behalf of the Dutch Sports Medicine Association (VSG)

Curriculum developed and coordinated by members of this ACE: Calcium and bone metabolism (Erasmus Arts 2007), Clinical technology (Medical Delta).

Also national patient education material was developed and implemented in primary care like the "Artrose wijzer", "het artrose handboek" for patients, and the Bone Center website.

Viability of Research, Education and Patient Care

We aim at balanced advanced knowledge sharing between disciplines and across ages by having frequent meetings within the specific research themes and across the themes. Four PhD students working in the calcium and bone metabolism group have started an international career, and we continuously aim at visiting fellowships for our own PhD students and postdocs.

Recently 7 PHD students within this ACE had an external international research period, one post-doc has a visiting professorship at the University of Brussels, and another post-doc at the university of Keele. Our PhD students have international publications and participate in international conferences, and serve several international boards. At the moment we have 5 visiting post-doc fellows. Talent is easily scouted during our meetings with research master students, but also through NIHES masters, summer school participation, and multiple international collaborations. We regularly publish with the international top in our field and have multiple publications in Nature, New Engl J Med, Nature Genetics, JAMA, Lancet, and BMJ.

Members of the ACE Bone & Joint play an important role in the European Reference Network for Rare Bone Diseases. The ACE Bone & Joint also includes some world leading experts; Prof. Bierma-Zeinstra is the 4th leading expert in osteoarthritis worldwide according to Expertscape based on 22000 articles (, and Prof. Mathijssen is the 3rd leading craniosynostoses expert worldwide based on 1800 articles (

Key and relevant publications of the last five years

  • Johansson et al. A meta-analysis of the association of fracture risk and body mass index in women. J Bone Min Res 2014 (145 citations)
  • Agricola, R.; Waarsing, J. H.; Thomas, G. E.; et al. Cam impingement: defining the presence of a cam deformity by the alpha angle. OSTEOARTHRITIS AND CARTILAGE 2014:22:218-225 (55 citations)
  • Kerkhof, H. J. M.; Bierma-Zeinstra, S. M. A.; Arden, N. K.; et al. Prediction model for knee osteoarthritis incidence, including clinical, genetic and biochemical risk factors. ANNALS OF THE RHEUMATIC DISEASES. 2014;73:2116-2121 (44 citations)
  • Oei, Ling; Koromani, Fjorda; Breda, Stephan J.; et al. Osteoporotic Vertebral Fracture Prevalence Varies Widely Between Qualitative and Quantitative Radiological Assessment Methods: The Rotterdam Study. JOURNAL OF BONE AND MINERAL RESEARCH 2018;33:560-568
  • Reurink, Gustaaf; Goudswaard, Gert Jan; Moen, Maarten H.; et al. Platelet-Rich Plasma Injections in Acute Muscle Injury. NEW ENGLAND JOURNAL OF MEDICINE 2014;370:2546-2548 (54 citations)
  • Styrkarsdottir, Unnur; Thorleifsson, Gudmar; Helgadottir, Hafdis T.; et al. Severe osteoarthritis of the hand associates with common variants within the ALDH1A2 gene and with rare variants at 1p31. NATURE GENETICS 2014;46:498-502 (51 citations)
  • Lankhorst, N. E.; van Middelkoop, M.; Crossley, K. M.; et al. Factors that predict a poor outcome 5-8 years after the diagnosis of patellofemoral pain: a multicentre observational analysis. BRITISH JOURNAL OF SPORTS MEDICINE 2016;50:881- (26 citations)
  • Lubberts E. The IL-23-IL-17 axis in inflammatory arthritis. NATURE REVIEWS RHEUMATOLOGY 2015:11:415-429 (84 citations)
  • Winkler, Thomas W.; Justice, Anne E.; Graff, Mariaelisa; et al. The Influence of Age and Sex on Genetic Associations with Adult Body Size and Shape: A Large-Scale Genome-Wide Interaction Study PLOS GENETICS Volume: 11 Issue: 10 Article Number: e1005378 Published: OCT 2015 (73 citations)
  • Reurink, Gustaaf; Brilman, Elisabeth G.; de Vos, Robert-Jan; et al.Magnetic Resonance Imaging in Acute Hamstring Injury: Can We Provide a Return to Play Prognosis? SPORTS MEDICINE Volume: 45 Issue: 1 Pages: 133-146 Published: JAN 2015 (35 citations)

PhD theses of the last five years

  • Ling Oei. Epidemiological radiological and genetic aspects of endocrine bone diseases, 2016
  • Rianne van der Heijden. Penetrating Patellofemoral Pain, 2016
  • Carolina Medina-Gomez. Disentangling the heterogeneity of Bone Accruel, 2016
  • Rianne van der Heijden. Patellofemoral pain: where does the pain come from?, 2016
  • Desiree Dorleijn. Hip osteoarthritis, 2017
  • Bastiaan de Vos. Beating obesity: efforts in preventing knee osteoarthritis, 2017
  • Alex Bastick. Symptomatic progression of knee and hip osteoarthritis in primary care, 2017
  • Annelies Ham. Medication use, Falls, and genetic variants in an older population. 2017
  • Marta Baroncelli.The Extracellular Matrix for Bone Regeneration: Interplay between mesenchymal stromal cells and the bone microenvironment, 2018
  • Tim Both. Beyond the dryness of Sjogren’s Syndrome, 2017

Non-scientific publications related to the ACE

  • Mc Alindon et al. OARSI guidelines for non-surgical management of OA. Osteoarthr Cartilage, 2014 (755 citations)
  • Pimentel, Ana; Urena-Torres, Pablo; Zillikens, M. Carola; et al. Fractures in patients with CKD-diagnosis, treatment, and prevention: a review by members of the European Calcified Tissue Society and the European Renal Association of Nephrology Dialysis and Transplantation KIDNEY INTERNATIONAL Volume: 92 Issue: 6 Pages: 1343-1355 Published: DEC 2017
  • Tsourdi, Elena; Langdahl, Bente; Cohen-Solal, Martine; et al. Discontinuation of Denosumab therapy for osteoporosis: A systematic review and position statement by ECTS. BONE Volume: 105 Pages: 11-17 Published: DEC 2017
  • Hadji, Peyman; Aapro, Matti S.; Body, Jean-Jacques; et al. Management of Aromatase Inhibitor-Associated Bone Loss (AIBL) in postmenopausal women with hormone sensitive breast cancer: Joint position statement of the IOF, CABS, ECTS, IEG, ESCEO, IMS, and SIOG JOURNAL OF BONE ONCOLOGY Volume: 7 Pages: 1-12 Published: JUN 2017
  • Diez-Perez, A.; Naylor, K. E.; Abrahamsen, B.; et al. International Osteoporosis Foundation and European Calcified Tissue Society Working Group. Recommendations for the screening of adherence to oral bisphosphonates OSTEOPOROSIS INTERNATIONAL Volume: 28 Issue: 3 Pages: 767-774 Published: MAR 2017
  • Collins, Natalie J.; Barton, Christian J.; van Middelkoop, Marienke; et al. 2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia, 2017 BRITTISH JOURNAL OF SPORTS MEDICINE Volume: 52 Issue: 18 Pages: 1170-1178 Published: SEP 2018
  • van Middelkoop, Marienke; Bennell, Kim L.; Callaghan, Michael J.; et al.International patellofemoral osteoarthritis consortium: Consensus statement on the diagnosis, burden, outcome measures, prognosis, risk factors and treatment. SEMINARS IN ARTHRITIS AND RHEUMATISM Volume: 47 Issue: 5 Pages: 666-675 Published: APR 2018
  • Weir, Adam; Brukner, Peter; Delahunt, Eamonn; et al.Doha agreement meeting on terminology and definitions in groin pain in athletes BRITTISH JOURNAL OF SPORTS MEDICINE Volume: 49 Issue: 12 Published: JUN 2015
  • Verhaar, J.A.N., J.B.A. Mourik, Leerboek orthopedie. Bohn Stafleu van Loghum | 3e druk, 2013 herdruk 2018
  • Bierma-Zeinstra & Vliet-Vlieland. Handboek voor mensen met artrose. Erasmus MC en LUMC, 2017
Last updated: 365 days ago.