Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 5/2015

01-05-2015 | Shoulder

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

Authors: Maurice Balke, Marco M. Schneider, Sven Shafizadeh, Holger Bäthis, Bertil Bouillon, Marc Banerjee

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 5/2015

Login to get access

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.
Literature
1.
go back to reference 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):848–850PubMed 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):848–850PubMed
2.
go back to reference 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):1082–1089CrossRefPubMed 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):1082–1089CrossRefPubMed
3.
go back to reference 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):955–960CrossRefPubMed 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):955–960CrossRefPubMed
4.
go back to reference 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):387–397CrossRefPubMed 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):387–397CrossRefPubMed
5.
go back to reference 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):575–581CrossRefPubMed 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):575–581CrossRefPubMed
6.
go back to reference Cox JS (1992) Current method of treatment of acromioclavicular joint dislocations. Orthopedics 15(9):1041–1044PubMed Cox JS (1992) Current method of treatment of acromioclavicular joint dislocations. Orthopedics 15(9):1041–1044PubMed
7.
go back to reference Elser F, Chernchujit B, Ansah P, Imhoff AB (2005) A new minimally invasive arthroscopic technique for reconstruction of the acromioclavicular joint. Unfallchirurg 108(8):645–649CrossRefPubMed Elser F, Chernchujit B, Ansah P, Imhoff AB (2005) A new minimally invasive arthroscopic technique for reconstruction of the acromioclavicular joint. Unfallchirurg 108(8):645–649CrossRefPubMed
8.
go back to reference 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] 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.
go back to reference Gstettner C, Tauber M, Hitzl W, Resch H (2008) Rockwood type III acromioclavicular dislocation: surgical versus conservative treatment. J Shoulder Elbow Surg 17(2):220–225CrossRefPubMed Gstettner C, Tauber M, Hitzl W, Resch H (2008) Rockwood type III acromioclavicular dislocation: surgical versus conservative treatment. J Shoulder Elbow Surg 17(2):220–225CrossRefPubMed
10.
go back to reference Imatani RJ, Hanlon JJ, Cady GW (1975) Acute, complete acromioclavicular separation. J Bone Joint Surg Am 57(3):328–332PubMed Imatani RJ, Hanlon JJ, Cady GW (1975) Acute, complete acromioclavicular separation. J Bone Joint Surg Am 57(3):328–332PubMed
11.
go back to reference 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] 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.
go back to reference 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):552–555PubMed 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):552–555PubMed
13.
go back to reference Phillips AM, Smart C, Groom AF (1998) Acromioclavicular dislocation. Conservative or surgical therapy. Clin Orthop Relat Res 353:10–17CrossRefPubMed Phillips AM, Smart C, Groom AF (1998) Acromioclavicular dislocation. Conservative or surgical therapy. Clin Orthop Relat Res 353:10–17CrossRefPubMed
14.
go back to reference Powers JA, Bach PJ (1974) Acromioclavicular separations. Closed or open treatment? Clin Orthop Relat Res 104:213–223CrossRefPubMed Powers JA, Bach PJ (1974) Acromioclavicular separations. Closed or open treatment? Clin Orthop Relat Res 104:213–223CrossRefPubMed
15.
go back to reference Rosslenbroich S, Wellmann M, Raschke MJ, Zantop T, Petersen W (2009) Minimalinvasive Akromioklavikulargelenk-Rekonstruktion (MINAR). Obere Extremität 4(3):154–159CrossRef Rosslenbroich S, Wellmann M, Raschke MJ, Zantop T, Petersen W (2009) Minimalinvasive Akromioklavikulargelenk-Rekonstruktion (MINAR). Obere Extremität 4(3):154–159CrossRef
16.
go back to reference 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):1507–1516CrossRefPubMed 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):1507–1516CrossRefPubMed
17.
go back to reference Taft TN, Wilson FC, Oglesby JW (1987) Dislocation of the acromioclavicular joint. An end-result study. J Bone Joint Surg Am 69(7):1045–1051PubMed Taft TN, Wilson FC, Oglesby JW (1987) Dislocation of the acromioclavicular joint. An end-result study. J Bone Joint Surg Am 69(7):1045–1051PubMed
18.
go back to reference 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):136–139CrossRefPubMed 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):136–139CrossRefPubMed
19.
go back to reference 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):615–621CrossRefPubMed 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):615–621CrossRefPubMed
Metadata
Title
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
Authors
Maurice Balke
Marco M. Schneider
Sven Shafizadeh
Holger Bäthis
Bertil Bouillon
Marc Banerjee
Publication date
01-05-2015
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 5/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2795-2

Other articles of this Issue 5/2015

Knee Surgery, Sports Traumatology, Arthroscopy 5/2015 Go to the issue