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Koxarthrosen im Erwerbsalter
Eine Übersicht zum aktuellen Erkenntnisstand

Coxarthrosis leads to a progressive destruction of the joint cartilage and has adverse effects on other joint structures. The diagnosis is made on the basis of the symptoms either alone or together with clinical evidence of functional disorders or the results of radiological/ imaging procedures. Thus there are large differences in reported incidences. Affected are mainly persons older than 45 years – mostly already of retirement age – and predominantly women. Biomechanical strain caused by sport, heavy work and physical strain, working in forced positions, repeated strain and vibration are said to have adverse effects as also is the inner biomechanical strain associated with being overweight.
The present publication aims to provide a review of the occupational medical significance of coxarthrosis, mainly in persons of working age, and to give a current view of potential causes and associations with workrelated strain. Therefore, unlike the approach taken in a systematic review, here studies of doubtful quality whose conclusions are worth checking are also included. Evidence of the role of work is provided by the repeatedly confirmed association with the handling of heavy loads, with work in farming and from accidents involving one-sided coxarthrosis. It is likely that relevant effects are only produced when the person has been subjected to strain from a number of different sources. That the hip joint is more tolerant of strain than the knee joint can be concluded from the fact that excess weight has less effect on the development of symmetrical coxarthrosis than on gonarthrosis.
The available data are insufficient for preventive measures in the form of recommendation of definite kinds and levels of strain. To this end further studies on the size of the effects of certain kinds of strain are necessary.