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Can we better predict which patients will develop knee osteoarthritis? During his PhD, Chien Nguyen focused on enhancing imaging techniques for knee osteoarthritis patients with leg malalignment. His goal was to shed light on the underlying causes of knee osteoarthritis. Chien successfully defended his PhD thesis on July 16. 

Malalignments of the leg, such as bowlegs or knock-knees, are known risk factors for knee osteoarthritis. These malalignments can place extra pressure on specific parts of the knee joint, increasing the risk of cartilage damage. “But not everyone with a leg malalignment ends up developing osteoarthritis,” says Nguyen. “We still don’t know exactly who is most at risk and why some patients deteriorate faster than others. I wanted to gain better insight into that.” 

Nguyen’s research contributed to improving radiographic imaging techniques to create better disease parameters. He developed more accurate and standardized imaging protocols to analyze leg malalignment and early signs of osteoarthritis. He also created automated software to assess joint damage on radiographs, making it easier to analyze large patient cohorts efficiently and consistently. 

We should consider leg malalignment itself as a disease

Rethinking knee osteoarthritis 

Chien’s research also raises new questions. “Maybe we should rethink the way we see this disease. Perhaps we should consider leg malalignment itself as a disease, instead of a risk factor for knee osteoarthritis. I think we should consider early intervention by correcting the malalignment in patients at high risk of knee osteoarthritis. That requires a shift in how we think about knee osteoarthritis.” A study investigating how to select patients for earlier intervention has already started by the successor of Chien’s project. 

More than research 

In the first half of his PhD, Chien focused mainly on 2D radiographs. Eventually, the focus shifted to 3D techniques. He worked on the development and implementation of various 3D techniques to further enhance the treatment and understanding of leg malalignment and knee osteoarthritis. This eventually led him to also start working in the at the UMC Utrecht. “The shift to start working as Coordinator of the 3D lab during my PhD felt natural, as I was already working a lot with 3D techniques.” 

Reflecting on his PhD, Nguyen highlights the freedom he was given. “There wasn’t a fixed project plan, so I had the space to think about the directions I wanted take.” His advice for future PhD candidates? “Take responsibility for deciding what you can and cannot do within your project. And don’t forget that a PhD is also a unique and fun experience where you get a lot of freedom and opportunities to learn.”  

Chien will continue working at the UMC Utrecht as Coordinator of the 3D lab, where he focuses on research, care and education. One of his goals is to further develop education in 3D technologies. “My dream is for future doctors to be more aware of how 3D technologies can support them and benefit their patients.”