Introduction and Aim: Discussion about
the role of concomitant factors, occupational
dose limits of physical stress for knee flexion
and the clinical and radiological picture of
the occupationally-induced osteoarthritis of
knee continues. There are no guidelines in
handling of this occupational disease. So it is
mandatory to develop recommendations for
medical evaluations.
In a previous paper we tried to design
general relationships and correlations between
the clinical picture of the occupational-
induced OA and the physical strain
respectively competing factors. In this contribution
we describe and discuss five cases
we agreed to the claim of occupational induction
of OA and proposed therefore acceptance
by the insurance. We try to picture
the way of our decision making process and
the consideration of concomitant factors.
Overall, we proposed acceptance of the
occupational-induced OA in 15 cases of 97
researched persons.
Methods: Anamnesis, lab test, clinical and
radiological examination were performed for
the evaluation. Almost all patients received
magnetic resonance tomographies of both
knees. Especially overweight and obesity,
malalignment, hyperuricemia, hypercholesterolemia
and sporting activity are lightened
as concomitant factors in this paper. But also
trauma, congenital influences and the role of
OA as a part of metabolic syndrome are discussed.
Conclusions: Existing concomitant factors
do not exclude the acknowledgment of an
occupational induced disease in general.
The magnetic resonance imaging was part
of an attempt to detect and describe stress
induced landmarks and giving a prognosis to
degeneration of the articular cartilage. A laboratory
examination seems to be essential.
We hope that the results of our evaluation
contribute to the development of recommendations
for medical case reviews.
They were presented and critically analysed
by the working group knee osteoarthritis of
German Social Accident Insurance.
