Osteoarthrosis (OA) is a common degenerative joint disorder in which the cartilage is more or less destroyed and the structure of the underlying bone is affected. Sometimes it is accompanied by few symptoms, but usually OA causes suffering, changes in ability to work and a decreased quality of life. Changes in the joint can be seen on x ray, and an OA sufferer usually seeks medical care because of pain, which is present even at rest, and a diminished range of motion. In severe cases, the joint may become totally stiff, and even destroyed. Surgery to replace a destroyed joint and replace it with a prosthesis is well developed today.
In Finland, Wickström compared concrete reinforcement workers with painters, but no differences in disability from the knees were found (Wickström et al. 1983). In a later Finnish study, knee disorders in carpet and floor layers and painters were compared (Kivimäki, Riihimäki and Hänninen 1992). Knee pain, knee accidents, and treatment regimes for the knees, as well as osteophytes around the patella, were more common among carpet and floor layers than among the painters. The authors suggest that kneeling work increases the risk of knee disorders and that the changes observed in x rays might be an initial sign of knee degeneration.
Orthotics and Prosthetics | Michigan Medicine - U of M Health
Frequent repetition of work movements and high force demands on the hand are powerful risk factors, especially when they occur together (Silverstein, Fine and Armstrong 1986). Generally accepted values for acceptable repetitiveness and use of force do not, however, yet exist (Hagberg et al. 1995). Being unaccustomed to hand-intensive work, either as a new worker or after an absence from work, increases the risk. Deviated or bent postures of the wrist at work and low environmental temperature have also been considered as risk factors, although the epidemiological evidence to support this is weak. Tenosynovitis and peritendinitis occur at all ages. Some evidence exists that women might be more susceptible than men (Silverstein, Fine and Armstrong 1986). This has, however, been difficult to investigate, because in many industries the tasks differ so widely between women and men. Tenosynovitis may be due to bacterial infection, and some systemic diseases such as rheumatoid arthritis and gout are often associated with tenosynovitis. Little is known about other individual risk factors.
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Spondylarthropathies have a strong genetic component since a majority of the patients have an inherited genetic marker, HLA-B27. The frequency of this marker is about 7 to 15% in Western populations; 90 to 100% of patients with ankylosing spondylitis and 70 to 90% of patients with reactive arthritis are HLA-B27 positive. However, at population levels, most of the subjects with this marker are healthy. Therefore, it is thought that exogenous factors, in addition to the genetic susceptibility, are needed for the development of the disease. Such triggering factors include bacterial infections in the urogenital tract or in the gut (table 6.10 ), skin lesions, and chronic inflammatory bowel diseases. The evidence in favour of infections is most direct in the case of reactive arthritis. Salmonella infections are widely increasing, as a sequel of which an increase in the cases with joint complications can be expected. Agriculture and poultry can be the sources of these infections. As to yersinia infections, pigs harbour yersinia bacteria in their tonsils. Slaughtering followed by storage of the meat products in the cold has been suggested to contribute to the dispersion of infections in humans. In patients with ankylosing spondylitis, however, usually no preceding infections can be traced as an initiating event. Recent results have, however, focused on the finding that patients with ankylosing spondylitis often have asymptomatic chronic gut inflammation, which could serve as a triggering factor or as a contributing inflammatory focus in the chronicity of the disease.
who decided to break the system and create the prosthesis ..
Other ailments with similar symptoms must be excluded. Widespread pain must be present for at least three months. In addition there must be pain in 11 of the 18 tender point sites shown in when pressed by an examiner's finger.