{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:35:51Z","timestamp":1790746551065,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:00:00Z","timestamp":1741824000000},"content-version":"vor","delay-in-days":71,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The aim of this study is to investigate the influence of patient\u2010specific factors, including age, lifestyle considerations as well as the extent of injury according to the Rockwood classification (RW), on the surgeon's decision\u2010making in the choice between operative and nonoperative treatment for acute, high\u2010grade acromioclavicular (AC) joint dislocations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Orthopaedic and trauma surgeons were requested to complete an online questionnaire consisting of closed and open questions regarding the treatment of acute, high\u2010grade AC joint dislocations and 24 fictive clinical scenarios.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 133 answered questionnaires were collected. 27 different nationalities from five continents were represented. The included participants had a median experience of 12 years (interquartile range: 2\u201341). Overall, the treatment option for surgery (answer: YES) was chosen in 2426 answers (76% of cases) compared to \u2018NO\u2019 in 766 (24% of cases). RW classification was considered the most important factor influencing surgical decision\u2010making for most surgeons (69%). Two thirds of the participants answered that smoking does not impact their decision towards surgery and as to the influence of body mass index (BMI) on decision\u2010making, half of the respondents would not alter their preferred treatment based on BMI. Finally, there were no significant differences in decision\u2010making regarding the influence of the participant's demographics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study highlights that RW classification is the most important factor to consider in the surgeon's decision\u2010making between operative and nonoperative treatment in acute, high\u2010grade AC joint dislocations. Participants preferred operative treatment over nonoperative treatment in acute, high\u2010grade AC joint dislocation in 76% of case scenarios, increasing up to 90% when RW Grade III lesions were not taken into account. These findings contrast with recent studies reporting good functional outcomes of conservatively treated acute, high\u2010grade AC injuries and highlight the need to bridge the gap between evidence and practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>Level V.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jeo2.70203","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T06:43:12Z","timestamp":1741848192000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Surgeons consider Rockwood classification the most important factor for decision\u2010making in acute, high\u2010grade acromioclavicular dislocations"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9749-3785","authenticated-orcid":false,"given":"Eduard","family":"Van Eecke","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Shoulder 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Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7162-1240","authenticated-orcid":false,"given":"Thibault","family":"Lafosse","sequence":"additional","affiliation":[{"name":"Clinique General Annecy, Alps Surgery Institute Annecy France"},{"name":"Hand, Upper Limb, Peripheral Nerve, Brachial Plexus and Microsurgery Unit Clinique G\u00e9n\u00e9rale Annecy Annecy France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7640-6945","authenticated-orcid":false,"given":"Antoon","family":"van Raebroeckx","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery VITAZ Sint\u2010Niklaas Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0301-3512","authenticated-orcid":false,"given":"Geert Alexander","family":"Buijze","sequence":"additional","affiliation":[{"name":"Hand, Upper Limb, Peripheral Nerve, Brachial Plexus and Microsurgery Unit Clinique G\u00e9n\u00e9rale Annecy Annecy France"},{"name":"Department of Orthopaedic Surgery, Amsterdam UMC University of Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1184-0529","authenticated-orcid":false,"given":"Michel","family":"van den Bekerom","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shoulder and Elbow Unit OLVG Amsterdam the Netherlands"},{"name":"Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences Vrije Universiteit Amsterdam Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"AC Instability Collaborator 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