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Current state of treatment of acute acromioclavicular joint injuries in Germany: is there a difference between specialists and non-specialists? A survey of German trauma and orthopaedic departments

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to evaluate currently preferred treatment strategies as well as the acceptance of new arthroscopic techniques among German orthopaedic surgeons. We assumed that surgeons specialized in shoulder surgery and arthroscopy would treat acute acromioclavicular joint dislocations different to non-specialized surgeons.

Methods

Seven hundred and ninety-six orthopaedic and/or trauma departments were found through the German hospital directory of 2012. Corresponding websites were searched for the email address of the chair of shoulder surgery (if applicable) or the department. Seven hundred forty-six emails with the request for study participation including a link to an online survey of 36 questions were sent. In 60 emails, the recipient was unknown.

Results

Two hundred and three (30 %) surgeons participated in the survey. one hundred and one were members of the AGA (German-speaking Society for Arthroscopy and Joint-Surgery) and/or of the DVSE (German Association of Shoulder and Elbow Surgery) and regarded as specialists, while 102 were non-members and regarded as non-specialists. According to the treatment of Rockwood I/II and IV–VI injuries, no significant differences were found. Seventy-four % of non-specialists and 67 % of specialists preferred surgical treatment for Rockwood III injuries (P = 0.046). Non-specialists would use the hook plate in 56 % followed by the TightRope in 16 %; specialists would use the TightRope in 38 % followed by the hook plate in 32 % (P = 0.004).

Conclusions

The majority of German orthopaedic and trauma surgeons advise surgical treatment for Rockwood III injuries. Specialists recommend surgery less often. Non-specialists prefer the hook plate, whereas specialists prefer the arthroscopic TightRope technique.

Level of evidence

Observational survey, Level IV.

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References

  1. Bannister GC, Wallace WA, Stableforth PG, Hutson MA (1989) The management of acute acromioclavicular dislocation. A randomised prospective controlled trial. J Bone Joint Surg Br 71(5):848–850

    CAS  PubMed  Google Scholar 

  2. Bathis H, Tingart M, Bouillon B, Tiling T (2000) Conservative or surgical therapy of acromioclavicular joint injury–what is reliable? A systematic analysis of the literature using “evidence-based medicine” criteria. Chirurg 71(9):1082–1089

    Article  CAS  PubMed  Google Scholar 

  3. Bathis H, Tingart M, Bouillon B, Tiling T (2001) The status of therapy of acromioclavicular joint injury. Results of a survey of trauma surgery clinics in Germany. Unfallchirurg 104(10):955–960

    Article  CAS  PubMed  Google Scholar 

  4. Beitzel K, Cote MP, Apostolakos J, Solovyova O, Judson CH, Ziegler CG, Edgar CM, Imhoff AB, Arciero RA, Mazzocca AD (2013) Current concepts in the treatment of acromioclavicular joint dislocations. Arthroscopy 29(2):387–397

    Article  PubMed  Google Scholar 

  5. Chernchujit B, Tischer T, Imhoff AB (2006) Arthroscopic reconstruction of the acromioclavicular joint disruption: surgical technique and preliminary results. Arch Orthop Trauma Surg 126(9):575–581

    Article  PubMed  Google Scholar 

  6. Cox JS (1992) Current method of treatment of acromioclavicular joint dislocations. Orthopedics 15(9):1041–1044

    CAS  PubMed  Google Scholar 

  7. Elser F, Chernchujit B, Ansah P, Imhoff AB (2005) A new minimally invasive arthroscopic technique for reconstruction of the acromioclavicular joint. Unfallchirurg 108(8):645–649

    Article  CAS  PubMed  Google Scholar 

  8. Glanzmann MC, Buchmann S, Audige L, Kolling C, Flury M (2013) Clinical and radiographical results after double flip button stabilization of acute grade III and IV acromioclavicular joint separations. Arch Orthop Trauma Surg [Epub ahead of print]

  9. Gstettner C, Tauber M, Hitzl W, Resch H (2008) Rockwood type III acromioclavicular dislocation: surgical versus conservative treatment. J Shoulder Elbow Surg 17(2):220–225

    Article  CAS  PubMed  Google Scholar 

  10. Imatani RJ, Hanlon JJ, Cady GW (1975) Acute, complete acromioclavicular separation. J Bone Joint Surg Am 57(3):328–332

    CAS  PubMed  Google Scholar 

  11. Jensen G, Katthagen JC, Alvarado LE, Lill H, Voigt C (2012) Has the arthroscopically assisted reduction of acute AC joint separations with the double tight-rope technique advantages over the clavicular hook plate fixation?. Knee Surg Sports Traumatol Arthrosc. [Epub ahead of print]

  12. Larsen E, Bjerg-Nielsen A, Christensen P (1986) Conservative or surgical treatment of acromioclavicular dislocation. A prospective, controlled, randomized study. J Bone Joint Surg Am 68(4):552–555

    CAS  PubMed  Google Scholar 

  13. Phillips AM, Smart C, Groom AF (1998) Acromioclavicular dislocation. Conservative or surgical therapy. Clin Orthop Relat Res 353:10–17

    Article  PubMed  Google Scholar 

  14. Powers JA, Bach PJ (1974) Acromioclavicular separations. Closed or open treatment? Clin Orthop Relat Res 104:213–223

    Article  PubMed  Google Scholar 

  15. Rosslenbroich S, Wellmann M, Raschke MJ, Zantop T, Petersen W (2009) Minimalinvasive Akromioklavikulargelenk-Rekonstruktion (MINAR). Obere Extremität 4(3):154–159

    Article  Google Scholar 

  16. Scheibel M, Droschel S, Gerhardt C, Kraus N (2011) Arthroscopically assisted stabilization of acute high-grade acromioclavicular joint separations. Am J Sports Med 39(7):1507–1516

    Article  PubMed  Google Scholar 

  17. Taft TN, Wilson FC, Oglesby JW (1987) Dislocation of the acromioclavicular joint. An end-result study. J Bone Joint Surg Am 69(7):1045–1051

    CAS  PubMed  Google Scholar 

  18. Tischer T, Salzmann GM, El-Azab H, Vogt S, Imhoff AB (2009) Incidence of associated injuries with acute acromioclavicular joint dislocations types III through V. Am J Sports Med 37(1):136–139

    Article  PubMed  Google Scholar 

  19. Venjakob AJ, Salzmann GM, Gabel F, Buchmann S, Walz L, Spang JT, Vogt S, Imhoff AB (2013) Arthroscopically assisted 2-bundle anatomic reduction of acute acromioclavicular joint separations: 58-month findings. Am J Sports Med 41(3):615–621

    Article  PubMed  Google Scholar 

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Correspondence to Maurice Balke.

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Balke, M., Schneider, M.M., Shafizadeh, S. et al. Current state of treatment of acute acromioclavicular joint injuries in Germany: is there a difference between specialists and non-specialists? A survey of German trauma and orthopaedic departments. Knee Surg Sports Traumatol Arthrosc 23, 1447–1452 (2015). https://doi.org/10.1007/s00167-013-2795-2

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