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Die BK 2112 aus gutachterlicher Sicht
Eine Darstellung zur Anerkennung empfohlener Fälle

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.