Damaged cartilage cannot heal because it is nonvascularized. Structurally, knee OA is characterized by the thinning and eventual disappearance of articular cartilage. 5 Patterns of OA have been linked with certain occupations, 6 and the job-related costs for medical treatment and lost productivity related to OA are in the billions of dollars. OA is a “whole joint” disease because every anatomical structure within and around a joint is affected. Osteoarthritis (OA) is a widely prevalent degenerative joint condition, affecting about 12% of the adult population in the US.
Tricompartmental degenerative changes free#
The Occupational Safety and Health Administration (OSHA) guidelines 4 mandate that an employer “shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm.” Many WC disputes on overuse injury arise from the nebulous statements “recognized hazards that are causing or are likely to cause” and “serious harm.” The biomechanics of osteoarthritis The opinion must be supported by evidence to a reasonable degree of scientific certainty, with the presiding judge determining the case outcome based on which side best demonstrated that standard. 3 Often, a witness will be asked to use his or her knowledge of biomechanics to provide an expert opinion supporting or refuting a causal relationship between work conditions (identifying a source of the loading) and an overuse injury (developing from a known loading pattern). Unlike the prosecution in a criminal case having to prove an accused individual’s guilt “beyond a reasonable doubt,” in a WC claim, showing causation requires support from a preponderance of the evidence, as carefully woven into a case by an attorney. Claims for overuse injury are frequently challenged by employers, particularly in the manufacturing sector, where WC expenses represent 3% of overall employee costs per hour. If the injury did not occur at work, any benefits must be covered through private insurance and not by WC. The task of separating possible work-related causes from possible away-from-work causes can be contentious in cases involving overuse injury. Overuse injuries are problematic because they develop from repetitive loading and not a single, isolated trauma. In cases of traumatic injury, it’s typically easy to isolate a single causative incident, such as a trip, fall, or crushing event. Appeals are generally limited, as one purpose of establishing WC was to reduce court adjudication of claims.Įstablishing that workplace conditions or events were responsible for an injury can be a contentious issue in WC. The board resolves contested claims by determining if an injury is work related.
Tricompartmental degenerative changes trial#
WC provides a form of disability, health, and life insurance, with disputed claims adjudicated by a state administrative board overseen by an administrative judge instead of through a trial court. 1 Under WC, employees forfeit the right to sue an employer for negligence in exchange for assured, but limited, compensation. WC programs began in the US in the early 1900s, and since 1949 all states have provided programs. The worker’s compensation (WC) program provides coverage for medical and economic costs, such as lost wages, resulting from a workplace injury. In such cases, particularly those involving workplace injuries, lower extremity biomechanics often plays a key role. The social and economic consequences of the assigned liability can be enormous. Determining cause and allocating responsibility are at the heart of financial settlements in both criminal and civil cases. Litigation following personal injury is widespread in today’s society.
In worker’s compensation cases, including those involving knee osteoarthritis, an expert witness often will be asked to use his or her knowledge of biomechanics to provide an opinion supporting or refuting a causal relationship between work conditions and an overuse injury.
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