Fietsen verstandig?


Bij hardlopen wordt de knie belast met 6x uw lichaamsgewicht bij elke stap

Máxima Medisch Centrum

Value-Based Health Care

ESSKA Accredited Teacher

Orthopedie Groot Eindhoven

Goede uitleg is essentieel voor juiste keuze behandeling


Voorste kruisbandreconstructie

Achterste kruisbandletsel

Zorg op maat

YouTube kanaal dr RPA Janssen

Internationaal wetenschappelijk onderzoek

Kruisbandoperaties knie

RPA Janssen MD PhD


Waardegedreven zorg

Last van knie-artrose?

Spreekuur / Policlinique / Outpatient clinic

Nederlandse Vereniging voor Arthroscopie

Máxima Medisch Centrum

Kruisbandoperaties bij kinderen

Veel pijn bij ernstige knie-artrose?

Samen met uw arts gekozen voor een knie-operatie?

Eenzijdige knie-artrose knie en actief leven?

Máxima Medisch Centrum Eindhoven-Veldhoven

Kwaliteit van leven

Samen kiezen voor de beste behandeling

Sporten met plezier

Oplossingen voor de lange termijn

Associate Professor Knee Reconstruction


Kneecap pain is a regular occurrence in fitness knee rehabilitation

Knee osteoarthritis

Cycling wise?


When running, the knee is loaded with 6x your body weight with each step

Study protocol ROTATE-trial: anterior cruciate ligament rupture, the influence of a treatment algorithm and shared decision making on clinical outcome- a cluster randomized controlled trial

de Vos, F. H., Meuffels, D. E., de Mul, M., Askari, M., Ista, E., Polinder, S., Waarsing, E., Bierma-Zeinstra, S. M. A., Reijman, M., & Janssen, R. P. A (ROTATE study group)
BMC Musculoskeletal Disorders, 2022;23(1):117. 10.1186/s12891-021-04867-5


Background: Anterior cruciate ligament (ACL) rupture is a very common knee injury in the sport active population. There is much debate on which treatment (operative or non-operative) is best for the individual patient. In order to give a more personalized recommendation we aim to evaluate the effectiveness and cost-effectiveness of a treatment algorithm for patients with a complete primary ACL rupture.

Methods: The ROTATE-trial is a multicenter, open-labeled cluster randomized controlled trial with superiority design. Randomization will take place on hospital level (n = 10). Patients must meet all the following criteria: aged 18 year or older, with a complete primary ACL rupture (confirmed by MRI and physical examination) and maximum of 6 weeks of non-operative treatment. Exclusion criteria consists of multi ligament trauma indicated for surgical intervention, presence of another disorder that affects the activity level of the lower limb, pregnancy, and insufficient command of the Dutch language. The intervention to be investigated will be an adjusted treatment decision strategy, including an advice from our treatment algorithm. Patient reported outcomes will be conducted at baseline, 3, 6, 12 and 24 months. Physical examination of the knee at baseline, 12 and 24 months. Primary outcome will be function of the knee measured by the International Knee Documentation Committee (IKDC) questionnaire. Secondary outcomes are, among others, the Tegner activity score, the Knee injury and Osteoarthritis Outcome Score (KOOS) and the 9-item Shared Decision Making Questionnaire (SDM-Q-9). Healthcare use, productivity and satisfaction with ((non-)operative) care are also measured by means of questionnaires. In total 230 patients will be included, resulting in 23 patients per hospital.

Discussion: The ROTATE study aims to evaluate the effectiveness and cost-effectiveness of a treatment algorithm for patients with a complete primary ACL rupture compared to current used treatment strategy. Using a treatment algorithm might give the much-wanted personalized treatment recommendation.

Trial registration: This study is approved by the Medical Research Ethics Committee of Erasmus Medical Center in Rotterdam and prospectively registered at the Dutch Trial Registry on May 13th, 2020. Registration number: NL8637.

Keywords: Anterior cruciate ligament rupture; Cost-effectiveness; Shared decision making; Treatment algorithm.