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.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Observational survey, Level IV.
authors.affiliation: Department of Trauma, Orthopaedic Surgery, and Sports Traumatology, Cologne Merheim Medical Center, University of Witten/Herdecke, Ostmerheimer Strasse 200, 51109, Cologne, Germany. maurice.balke@gmail.com.
authors.forename: Maurice
authors.initials: M
authors.lastname: Balke
authors.affiliation: Department of Trauma, Orthopaedic Surgery, and Sports Traumatology, Cologne Merheim Medical Center, University of Witten/Herdecke, Ostmerheimer Strasse 200, 51109, Cologne, Germany.
authors.forename: Marco M
authors.initials: MM
authors.lastname: Schneider
authors.affiliation: Department of Trauma, Orthopaedic Surgery, and Sports Traumatology, Cologne Merheim Medical Center, University of Witten/Herdecke, Ostmerheimer Strasse 200, 51109, Cologne, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Shafizadeh
authors.affiliation: Department of Trauma, Orthopaedic Surgery, and Sports Traumatology, Cologne Merheim Medical Center, University of Witten/Herdecke, Ostmerheimer Strasse 200, 51109, Cologne, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Bäthis
authors.affiliation: Department of Trauma, Orthopaedic Surgery, and Sports Traumatology, Cologne Merheim Medical Center, University of Witten/Herdecke, Ostmerheimer Strasse 200, 51109, Cologne, Germany.
authors.forename: Bertil
authors.initials: B
authors.lastname: Bouillon
authors.affiliation: Department of Trauma, Orthopaedic Surgery, and Sports Traumatology, Cologne Merheim Medical Center, University of Witten/Herdecke, Ostmerheimer Strasse 200, 51109, Cologne, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Banerjee
mesh_terms: D000173:Acromioclavicular Joint / Q000293:injuries* / Q000601:surgery; D001182:Arthroscopy / Q000379:methods*; D002983:Clinical Competence; D005858:Germany; D006801:Humans; D009985:Orthopedics; D012783:Shoulder Dislocation / Q000209:etiology / Q000601:surgery*; D013038:Specialization; D011795:Surveys and Questionnaires; D014193:Trauma Centers; D000078329:Workforce