Portrait series of new Medical Delta professors - Jaap Harlaar: "This form of collaboration is in my blood"

Hundreds of thousands of Dutch people suffer from pain due to knee osteoarthritis, and that number is rising rapidly. Prof.dr.ir. Jaap Harlaar specialises in clinical biomechanics and his research contributes to better treatment of osteoarthritis. Harlaar has been appointed Medical Delta Professor and now holds appointments at TU Delft, LUMC and Erasmus MC. This helps him in his work. "You have to cross disciplinary boundaries to tackle a disease like osteoarthritis," he says.

"With osteoarthritis, you have to understand what happens at the cellular level of the cartilage and you have to understand how the cartilage is strained during movement," Harlaar says. "You can express the importance of collaboration in a metric scale. I look at a patient from the metre to the millimetre, fellow biomechanist Amir Zadpoor looks from the millimetre to the micrometre and medical biologist Gerjo van Osch looks isnside the cells at a micrometer level. We need each other to unravel a disease."

What does the appointment as Medical Delta professor mean to you?

"This form of cooperation is in my blood, since I have been working with LUMC and Erasmus MC for a long time. In that respect, nothing much will change. But Medical Delta does help. It gives an extra push to get new things done, which makes it a factor of significance. For example, it has a positive effect on our grant applications. It speeds up our research and gives us a faster impact for the patient. Internally, it helps to raise our profile. With the appointment of the professors, we send the message: as universities, we value collaboration’. This gives us more influence on the set-up of faculties and the direction of research.

Medical Delta's vision is that we do not conduct science for the sake of science, but for the impact on healthcare. I completely support that and that is also my motivation to collaborate."

What do patients gain from these collaborations?

"Osteoarthritis is a complex disease and varies greatly from one patient to the next. Precise diagnostics are necessary to find the best treatment- we can only offer this through far-reaching cooperation. That is why we are developing a new field lab at Erasmus MC, for instance. Here we combine imaging, with input from radiologist Edwin Oei, and ‘my’ biomechanics. In doing so, we can discern very precisely what is going on for each individual. This directs the treatment, but biomechanics is not the only thing that counts. Patient preferences are important as well. One person might want to be operated and get an artificial knee as quickly as possible. Someone else could prefer to avoid surgery at all costs. There are many other options in between. It is mainly the orthopaedic surgeons in Leiden and Rotterdam who conduct the conversations about this and we also involve them in the research."

You have been programme director of the studies Clinical Technology and Technical Medicine since 2018. What role does Medical Delta play?

"We train students in both the medical and technical fields. They will become 80 per cent doctors and 80 per cent engineers. This means they perfectly fit in with the Medical Delta vision. In this way, we ensure that Medical Delta is nurtured and grows in the future. In order to achieve this, we need teachers with the same mind-set. Teachers who understand that you have to collaborate to achieve impact. That is why I favour appointing lecturers in addition to professors. And it would be positive if the students of the programme graduated in the research areas of Medical Delta."

What is your advice for a successful collaboration?

"It is important to invest in your knowledge of the field of your research partners. When I came to work at the clinic years ago, I looked down on how simple doctors sometimes reason. 'I see this, so then that.' It took me a while to understand that a doctor has a patient who wants an answer. The doctor has to deal with unknown complexities and relies on statistical considerations. At the other end, a doctor often has to get used to how much time an engineer needs to work out a solution based on causal relationships. You have to be open to the problems that the other person is facing."

What other researcher surprised you?

"Surprise would be an overstatement, but someone I work with and learn from a lot, is Sita Bierma-Zeinstra of Erasmus MC. It is important to put biomechanics in the context of a disease, in this case osteoarthritis, and she knows an incredible lot about it."

This article is part of a series in which we highlight the nine new Medical Delta professors. Jaap Harlaar's research contributes to the scientific programme of Medical Delta: Improving Mobility with Technology. The inauguration of Jaap Harlaar and eight other new Medical Delta professors can be seen here.