A NATIONWIDE German analysis has revealed that hospitalisation patterns in inflammatory rheumatic diseases have changed substantially over the past decade, with orthopaedic surgical interventions continuing to play a key role despite advances in disease-modifying drug therapy.
Inflammatory rheumatic diseases have remained major contributors to morbidity and healthcare utilisation worldwide. Advances in disease-modifying antirheumatic drug therapy have substantially changed disease management in recent years and may have influenced patterns of inpatient care and orthopaedic surgical treatment, yet nationwide data on long-term hospitalisation trends remained limited.
Researchers conducted a nationwide analysis of aggregated inpatient hospital discharge 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, while orthopaedic procedures were analysed using diagnosis-related group data from the German Institute for the Hospital Remuneration System (InEK). Osteomyelitis was included as a comparator musculoskeletal disorder.
Hospitalisation trends differed substantially across disease groups. RA hospitalisations declined from 29,775 cases in 2010 to 24,992 cases in 2023, a reduction of 16.1%, while JIA showed the largest decline, at 43.0%. PsA hospitalisations increased by 7.6%, while AS remained largely stable, rising by 2.9%. Osteomyelitis showed an overall stable pattern, and a marked reduction in hospitalisations was observed across all disease groups in 2020. Age-standardised hospitalisation rates largely mirrored these findings, with RA falling 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.
These findings demonstrate that despite advances in medical therapy, orthopaedic surgical interventions continue to represent an important component of disease management, underscoring the ongoing need for integrated rheumatologic and orthopaedic care.
Reference
Anees H et al. Changing patterns of hospitalisation and orthopaedic procedure profiles in major inflammatory rheumatic diseases in Germany: a nationwide analysis of hospital discharge data. Rheumatol Int. 2026;46:197.
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