{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T04:24:28Z","timestamp":1786940668772,"version":"build-2736575974"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Justus-Liebig-Universit\u00e4t Gie\u00dfen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Rheumatol Int"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Inflammatory rheumatic diseases are major contributors to morbidity and healthcare utilisation worldwide. Advances in disease-modifying antirheumatic drug therapy have substantially changed disease management and may have influenced patterns of inpatient care and orthopaedic surgical treatment. However, nationwide data on long-term hospitalisation trends remain limited.\u00a0This nationwide analysis of aggregated inpatient hospital discharge data was based on data from the German Federal Health Monitoring system (GBE-Bund) between 2010 and 2023. Hospitalisations associated with rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), juvenile idiopathic arthritis (JIA), and osteomyelitis were identified using ICD-10-GM codes. Orthopaedic procedures were analysed using diagnosis-related group data from the German Institute for the Hospital Remuneration System (InEK).\u00a0Hospitalisation trends differed substantially across disease groups. RA hospitalisations declined from 29,775 cases in 2010 to 24,992 cases in 2023 (\u2212\u200916.1%), while JIA showed the largest reduction (\u2212\u200943.0%). In contrast, PsA hospitalisations increased (+\u20097.6%), whereas AS remained largely stable (+\u20092.9%). Osteomyelitis, included as a comparator musculoskeletal disorder, showed an overall stable pattern. A marked reduction in hospitalisations was observed across all disease groups in 2020. Age-standardised hospitalisation rates largely mirrored these findings, with RA decreasing from 40 to 30 and JIA from 7 to 4 hospitalisations per 100,000 population between 2010 and 2023. Distinct orthopaedic procedure profiles were identified, with knee and hip replacement procedures predominating in RA and spine-related interventions predominating in AS.\u00a0Nationwide hospitalisation patterns in inflammatory rheumatic diseases have changed substantially over the past decade. Despite advances in medical therapy, orthopaedic surgical interventions continue to represent an important component of disease management, highlighting the continued need for integrated rheumatologic and orthopaedic care.<\/jats:p>","DOI":"10.1007\/s00296-026-06247-5","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T04:28:48Z","timestamp":1783744128000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changing Patterns of Hospitalisation and Orthopaedic Procedure Profiles in Major Inflammatory Rheumatic Diseases in Germany: a Nationwide Analysis of Hospital Discharge Data"],"prefix":"10.1007","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2427-0841","authenticated-orcid":false,"given":"Houmam","family":"Anees","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5381-9392","authenticated-orcid":false,"given":"Reem","family":"Jamous","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Heiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1187-8578","authenticated-orcid":false,"given":"Thaqif","family":"El Khassawna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2981-5062","authenticated-orcid":false,"given":"Christoph","family":"Biehl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,11]]},"reference":[{"key":"6247_CR1","doi-asserted-by":"publisher","first-page":"2023","DOI":"10.1016\/S0140-6736(16)30173-8","volume":"388","author":"JS Smolen","year":"2016","unstructured":"Smolen JS, Aletaha D, McInnes IB (2016) Rheumatoid arthritis. 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Arthritis Res Ther. https:\/\/doi.org\/10.1186\/s13075-023-03251-z","journal-title":"Arthritis Res Ther"}],"container-title":["Rheumatology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00296-026-06247-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00296-026-06247-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00296-026-06247-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T03:37:41Z","timestamp":1786937861000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00296-026-06247-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,11]]},"references-count":19,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["6247"],"URL":"https:\/\/doi.org\/10.1007\/s00296-026-06247-5","relation":{},"ISSN":["1437-160X"],"issn-type":[{"value":"1437-160X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,11]]},"assertion":[{"value":"30 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was not required for this study because it was based exclusively on anonymised, aggregated administrative data obtained from the publicly accessible German Federal Health Monitoring System (GBE-Bund) and the InEK DRG browser (\n                      \n                      ). No individual-level or identifiable patient data were accessed or processed. The analysed data are publicly available and provided in aggregated form; therefore, informed consent was not required.","order":2,"name":"Ethics","label":"Ethical approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Artificial intelligence-assisted tools were used for language improvement and editorial support during manuscript preparation. All scientific content, study design, data collection, analyses, interpretation of results, and conclusions were developed, verified, and approved by the authors. The authors reviewed and edited the final manuscript and take full responsibility for its content.","order":3,"name":"Ethics","label":"AI use statement","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This manuscript represents original work that has not been published previously and is not under consideration for publication elsewhere. All scientific content, analyses, interpretations, and conclusions were developed and verified by the authors, who take full responsibility for the integrity and accuracy of the work.","order":4,"name":"Ethics","label":"Disclaimer","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Part of this work has been accepted for presentation at the Deutscher Rheumatologiekongress 2026 (German Congress of Rheumatology), Leipzig, Germany, 9\u201312 September 2026, as Poster RO.06 in the session \u201cPW25 \u2013 Rheuma-Orthop\u00e4die 1\u201d under the title \u201cOrthopaedic Surgical Patterns in Inflammatory Rheumatic Diseases in Germany: Nationwide Hospitalisation Trends and DRG-Based Procedure Analysis\u201d. The present manuscript represents the full report of the study. At the time of submission of the revised manuscript, no bibliographic citation or DOI for the conference abstract was available.","order":5,"name":"Ethics","label":"Conference presentation","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Procedure frequencies were extracted from the German Institute for the Hospital Remuneration System (InEK) DRG browser (DRG version 2024, grouped according to the 2025 classification) using disease-specific ICD-10-GM principal diagnoses. Rheumatoid arthritis (RA) was defined by ICD-10-GM codes M05 and M06, excluding M05.1x, M05.2x, M06.1, and M06.3. Knee replacement procedures were identified using OPS code group 5-822, hip replacement procedures using OPS code group 5-820, and spine-related procedures in ankylosing spondylitis (AS) using selected OPS 5-83x codes. Procedure counts represent case-level frequencies (\u201cF\u00e4lle\u201d) as reported by the InEK DRG browser. For RA, total procedure frequencies were calculated by combining the corresponding M05 and M06 results. Cases refer to inpatient hospital cases reported by the InEK DRG browser and not to individual patients.","order":6,"name":"Ethics","label":"Supplementary Table S1. OPS code groups used for the orthopaedic procedure profile analysis","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"197"}}