Evolution and trends in the management of acromioclavicular joint dislocations: an epidemiological analysis from Germany between 2013 and 2023
Objective: This study aims to analyze nationwide trends in the management of hospitalized patients with acromioclavicular joint dislocations (ACJDs) in Germany over the past decade, focusing on surgical procedures and demographic patient data. The investigation examines the shift from conventional o...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-07-01
|
| Series: | JSES International |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666638325000878 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850114475186716672 |
|---|---|
| author | Philipp Herrmann, MD Martin Luedemann, MD Thilo Lehmeyer, MD Sebastian Frischholz, MD Maximilian Rudert, MD Kilian List, MD Ioannis Stratos, MD Felix Hochberger, MD |
| author_facet | Philipp Herrmann, MD Martin Luedemann, MD Thilo Lehmeyer, MD Sebastian Frischholz, MD Maximilian Rudert, MD Kilian List, MD Ioannis Stratos, MD Felix Hochberger, MD |
| author_sort | Philipp Herrmann, MD |
| collection | DOAJ |
| description | Objective: This study aims to analyze nationwide trends in the management of hospitalized patients with acromioclavicular joint dislocations (ACJDs) in Germany over the past decade, focusing on surgical procedures and demographic patient data. The investigation examines the shift from conventional open stabilization techniques to mini-open and arthroscopically assisted approaches. Materials and methods: Hospital billing data from the Federal Statistical Office of Germany (2013-2023) were analyzed, including patients diagnosed with ACJD (International Classification of Diseases-10: primary diagnosis International Classification of Diseases S43.1) who underwent surgical reconstruction of the ACJD (German Operation and Procedure Classification System codes: 5-814b, 5-807.4, 5-807.5, 5-807.6, 5-930.0, 5-852.f, and 5-852.f8). Data included year of diagnosis, patient sex, surgical codes, and age (grouped in 5-year intervals). Data processing used R software for transformation and Tableau Desktop for subgroup analyses, stratified by type of procedure type, sex, and age. Statistical analyses, including linear regression and chi-squared tests, were conducted using GraphPad Prism (GraphPad Software, Inc., San Diego, CA, USA). Statistical significance was set at P ≤ .05. Results: From 2013 to 2023, 82,254 patients were hospitalized and surgically treated for ACJD in Germany, indicating a decline in inpatient surgical management (P < .05). This reduction primarily reflects a decrease in the number of inpatient procedures rather than changes in hospitalization duration or a shift toward outpatient surgery. Arthroscopically assisted stabilization increased from 19.6% in 2013 to 37.5% in 2023, becoming the most common surgical technique, while open techniques, such as plate stabilization and screw or Kirschner wire fixation, significantly decreased (P < .05). Tendon augmentation procedures showed a notable rise despite their rarity (P < .005). Arthroscopic techniques were predominantly used in younger patients (mean age: 39.6 years), while open reduction with plates was the most commonly used method in the age group over 60 years (P < .05). ACJD incidence was 8.2 times higher in men than women, with significant male dominance across all surgical techniques (P < .05). Conclusions: Over the past decade, the management of ACJD s in Germany has shifted toward arthroscopically assisted stabilization, particularly in younger patients, while traditional open techniques have declined. Numbers of hospitalized treated cases have decreased, with a strong male predominance and age-related preferences influencing surgical approaches. |
| format | Article |
| id | doaj-art-77e61bb3cd3943b692c87b0896a82f7e |
| institution | OA Journals |
| issn | 2666-6383 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES International |
| spelling | doaj-art-77e61bb3cd3943b692c87b0896a82f7e2025-08-20T02:36:50ZengElsevierJSES International2666-63832025-07-01941040104710.1016/j.jseint.2025.03.005Evolution and trends in the management of acromioclavicular joint dislocations: an epidemiological analysis from Germany between 2013 and 2023Philipp Herrmann, MD0Martin Luedemann, MD1Thilo Lehmeyer, MD2Sebastian Frischholz, MD3Maximilian Rudert, MD4Kilian List, MD5Ioannis Stratos, MD6Felix Hochberger, MD7Department of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Wuerzburg, GermanyDepartment of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Wuerzburg, GermanyDepartment of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Wuerzburg, GermanyDepartment of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Wuerzburg, GermanyDepartment of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Wuerzburg, GermanyDepartment of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Wuerzburg, GermanyDepartment of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Wuerzburg, GermanyCorresponding author: Felix Hochberger, MD, Department of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Brettreichstrasse 11, Wuerzburg 97074, Germany.; Department of Orthopaedic Surgery, Julius-Maximilians University Wuerzburg, Koenig-Ludwig-Haus, Wuerzburg, GermanyObjective: This study aims to analyze nationwide trends in the management of hospitalized patients with acromioclavicular joint dislocations (ACJDs) in Germany over the past decade, focusing on surgical procedures and demographic patient data. The investigation examines the shift from conventional open stabilization techniques to mini-open and arthroscopically assisted approaches. Materials and methods: Hospital billing data from the Federal Statistical Office of Germany (2013-2023) were analyzed, including patients diagnosed with ACJD (International Classification of Diseases-10: primary diagnosis International Classification of Diseases S43.1) who underwent surgical reconstruction of the ACJD (German Operation and Procedure Classification System codes: 5-814b, 5-807.4, 5-807.5, 5-807.6, 5-930.0, 5-852.f, and 5-852.f8). Data included year of diagnosis, patient sex, surgical codes, and age (grouped in 5-year intervals). Data processing used R software for transformation and Tableau Desktop for subgroup analyses, stratified by type of procedure type, sex, and age. Statistical analyses, including linear regression and chi-squared tests, were conducted using GraphPad Prism (GraphPad Software, Inc., San Diego, CA, USA). Statistical significance was set at P ≤ .05. Results: From 2013 to 2023, 82,254 patients were hospitalized and surgically treated for ACJD in Germany, indicating a decline in inpatient surgical management (P < .05). This reduction primarily reflects a decrease in the number of inpatient procedures rather than changes in hospitalization duration or a shift toward outpatient surgery. Arthroscopically assisted stabilization increased from 19.6% in 2013 to 37.5% in 2023, becoming the most common surgical technique, while open techniques, such as plate stabilization and screw or Kirschner wire fixation, significantly decreased (P < .05). Tendon augmentation procedures showed a notable rise despite their rarity (P < .005). Arthroscopic techniques were predominantly used in younger patients (mean age: 39.6 years), while open reduction with plates was the most commonly used method in the age group over 60 years (P < .05). ACJD incidence was 8.2 times higher in men than women, with significant male dominance across all surgical techniques (P < .05). Conclusions: Over the past decade, the management of ACJD s in Germany has shifted toward arthroscopically assisted stabilization, particularly in younger patients, while traditional open techniques have declined. Numbers of hospitalized treated cases have decreased, with a strong male predominance and age-related preferences influencing surgical approaches.http://www.sciencedirect.com/science/article/pii/S2666638325000878Shoulder surgeryArthroscopic stabilizationHospitalizationDemographic analysisAcromioclavicular injuriesEpidemiology |
| spellingShingle | Philipp Herrmann, MD Martin Luedemann, MD Thilo Lehmeyer, MD Sebastian Frischholz, MD Maximilian Rudert, MD Kilian List, MD Ioannis Stratos, MD Felix Hochberger, MD Evolution and trends in the management of acromioclavicular joint dislocations: an epidemiological analysis from Germany between 2013 and 2023 JSES International Shoulder surgery Arthroscopic stabilization Hospitalization Demographic analysis Acromioclavicular injuries Epidemiology |
| title | Evolution and trends in the management of acromioclavicular joint dislocations: an epidemiological analysis from Germany between 2013 and 2023 |
| title_full | Evolution and trends in the management of acromioclavicular joint dislocations: an epidemiological analysis from Germany between 2013 and 2023 |
| title_fullStr | Evolution and trends in the management of acromioclavicular joint dislocations: an epidemiological analysis from Germany between 2013 and 2023 |
| title_full_unstemmed | Evolution and trends in the management of acromioclavicular joint dislocations: an epidemiological analysis from Germany between 2013 and 2023 |
| title_short | Evolution and trends in the management of acromioclavicular joint dislocations: an epidemiological analysis from Germany between 2013 and 2023 |
| title_sort | evolution and trends in the management of acromioclavicular joint dislocations an epidemiological analysis from germany between 2013 and 2023 |
| topic | Shoulder surgery Arthroscopic stabilization Hospitalization Demographic analysis Acromioclavicular injuries Epidemiology |
| url | http://www.sciencedirect.com/science/article/pii/S2666638325000878 |
| work_keys_str_mv | AT philippherrmannmd evolutionandtrendsinthemanagementofacromioclavicularjointdislocationsanepidemiologicalanalysisfromgermanybetween2013and2023 AT martinluedemannmd evolutionandtrendsinthemanagementofacromioclavicularjointdislocationsanepidemiologicalanalysisfromgermanybetween2013and2023 AT thilolehmeyermd evolutionandtrendsinthemanagementofacromioclavicularjointdislocationsanepidemiologicalanalysisfromgermanybetween2013and2023 AT sebastianfrischholzmd evolutionandtrendsinthemanagementofacromioclavicularjointdislocationsanepidemiologicalanalysisfromgermanybetween2013and2023 AT maximilianrudertmd evolutionandtrendsinthemanagementofacromioclavicularjointdislocationsanepidemiologicalanalysisfromgermanybetween2013and2023 AT kilianlistmd evolutionandtrendsinthemanagementofacromioclavicularjointdislocationsanepidemiologicalanalysisfromgermanybetween2013and2023 AT ioannisstratosmd evolutionandtrendsinthemanagementofacromioclavicularjointdislocationsanepidemiologicalanalysisfromgermanybetween2013and2023 AT felixhochbergermd evolutionandtrendsinthemanagementofacromioclavicularjointdislocationsanepidemiologicalanalysisfromgermanybetween2013and2023 |