The fifty most cited Latin-American articles in the orthopaedic literature

Purpose

The number of citations of an article is a marker of its academic influence. Several medical specialties, including orthopaedics, have ranked the articles with more citations. We identified the 50 most cited orthopaedic articles from Latin-America and analyzed the characteristics that made them citable.

Methods

Science Citation Index Expanded was searched for citations of articles originated in Latin-America, published in any of the 63 journals in the category “Orthopaedics” from 1988 to 2013. We created a list ranking the 50 most commonly cited articles and determined the citation density (Citations/years since publication). Information noted for each article included authors, year of publication, country of origin, source journal, article type, and field of research.

Results

Latin-American countries were the origin of 1 % of orthopaedic articles. The top 50 most cited articles had between 29 and 150 citations (mean, 44.48); the citation density ranged from 1.43 to 15.5 citations/years (mean, 5.25). The articles were published in 19 of the 63 journals (11 general and eight sub-specialty journals), and all were published in English. Most articles (n = 29) were published in 2000 or later. The majority were clinical articles (n=40), and the most common fields were arthroscopy (n = 15) and hip surgery (n = 13). The top 50 articles originated mainly from Brazil (n = 20) and Argentina (n = 15).

Conclusions

This top 50 list displays articles that have become important references for the orthopaedic scientific community. Researchers may use this work to make their future publications more influential on future investigators.     

Analysis of Orthopaedic Research Produced During the Wars in Iraq and Afghanistan

Background

Military orthopaedic surgeons have published a substantial amount of original research based on our care of combat-wounded service members and related studies during the wars in Iraq and Afghanistan. However, to our knowledge, the influence of this body of work has not been evaluated bibliometrically, and doing so is important to determine the modern impact of combat casualty research in the wider medical community.

Questions/purposes

We sought to identify the 20 most commonly cited works from military surgeons published during the Iraq and Afghanistan conflicts and analyze them to answer the following questions: (1) What were the subject areas of these 20 articles and what was the 2013 Impact Factor of each journal that published them? (2) How many citations did they receive and what were the characteristics of the journals that cited them? (3) Do the citation analysis results obtained from Google Scholar mirror the results obtained from Thompson-Reuters’ Web of Science?

Methods

We searched the Web of Science Citation Index Expanded for relevant original research performed by US military orthopaedic surgeons related to Operation Iraqi Freedom and Operation Enduring Freedom between 2001 and 2014. Articles citing these studies were reviewed using both Web of Science and Google Scholar data. The 20 most cited articles meeting inclusion criteria were identified and analyzed by content domain, frequency of citation, and sources in which they were cited.

Results

Nine of these studies examined the epidemiology and outcome of combat injury. Six studies dealt with wound management, wound dehiscence, and formation of heterotopic ossification. Five studies examined infectious complications of combat trauma. The median number of citations garnered by these 20 articles was 41 (range, 28–264) in Web of Science. Other research citing these studies has appeared in 279 different journals, covering 26 different medical and surgical subspecialties, from authors in 31 different countries. Google Scholar contained 97% of the Web of Science citations, but also had 31 duplicate entries and 29 citations with defective links.

Conclusions

Modern combat casualty research by military orthopaedic surgeons is widely cited by researchers in a diverse range of subspecialties and geographic locales. This suggests that the military continues to be a source of innovation that is broadly applicable to civilian medical and surgical practice and should encourage expansion of military-civilian collaboration to maximize the utility of the knowledge gained in the treatment of war trauma.

Level of Evidence

Level IV, therapeutic study.     

Hand-Assist Laparoscopic Surgery for the Gynecologic Surgeon

Background:

Hand assist laparoscopy (HALS) is a minimally invasive technique which allows for the placement of the surgeon''s non-dominant hand through a hand-port device while maintaining pneumoperitoneum. There is no standardization of this procedure and it is rarely used in gynecology.

Methods:

The multidisciplinary team of authors, with experience in minimally invasive pelvic surgery, has developed a practical approach performing HALS over several years. Here we present our technique.

Conclusions:

There are several roles for HALS in the world of gynecology and pelvic surgery. Further experience will help improve upon a standard technique.     

Association of scientific and nonscientific factors to citation rates of articles of renowned orthopedic journals

Purpose

The physician often relies on the prestige of a journal to identify the most relevant articles to be read in his field. This investigation studied associations of scientific and nonscientific criteria with the citation frequency of articles in two top-ranked international orthopedic journals.

Methods

The 100 most (mean, 88 citations/5 years for cases) and 100 least (mean, two citations/5 years for controls) cited articles published between 2000 and 2004 in the Journal of Bone and Joint Surgery and the Bone & Joint Journal (formerly known as JBJS (Br)), two of the most distributed general orthopedic journals, were identified. The association of scientific and nonscientific factors on their citation rate was quantified.

Results

Randomized controlled trials, as well as multicenter studies with large sample sizes, were significantly more frequent in the high citation rate group. The unadjusted odds of a highly cited article to be supported by industry were 2.8 (95 % confidence interval 1.5, 5.6; p?<?0.05) if compared with a lowly cited article.

Conclusion

Beside scientific factors, nonscientific factors such as industrial support seem associated to the citation rate of published articles. This, together with publication bias, questions whether scientific facts reach the readers in a balanced fashion. Level of Evidence 3     

Origins of the Canadian school of surgery

Background

Since its inception 50 years ago, the Canadian Journal of Surgery has published articles under the banner “History of Canadian Surgery.” Because no comprehensive history of surgery in this country has yet been written, these articles may provide its basis.

Method

The Canadian Journal of Surgery was searched from October 1957 to August 2007 for articles on the practice of surgery in Canada before 1957. Articles regarding the development of surgery in provinces, universities, hospitals and surgical specialty societies were included, as well as biographies and obituaries of surgeons.

Results

Thirty-six articles dealing with the lives of 57 Canadian surgeons were located. Three periods of Canadian surgery were covered: the French regime (1535–1759), the transition period (1759–1870) and the early modern period (1870–1945). The review shows that persistent efforts were made in Canada to develop surgical education and to regulate the practice of surgery. Isolation forced a spirit of adaptability that led to innovation and progress.

Conclusion

The practice of surgery in Canada today can be traced back to contributions made by pioneering surgeons over the entire history of modern Canada. An archive of materials related to the history of surgery in Canada is being created at www.historyofsurgery.ca to facilitate further research.     

Hand surgery after axillary lymph node clearance for breast cancer: contra-indication to surgery?

INTRODUCTION

Breast cancer patients who have had prior axillary lymph node clearance (ALNC) can present with ipsi lateral hand conditions that could easily be treated with surgical intervention. These patients are often advised to avoid interventional procedures due to risks of complications such as lymphoedema, infection and cellulitis.

SUBJECTS AND METHODS

Between April and June 2009, we conducted an online survey of hand surgeons, breast surgeons and breast-care nurses to obtain their views on hand surgery after ipsilateral axillary lymph node clearance.

RESULTS

The majority of hand surgeons (58%) felt there was no contra-indication to surgery in a breast cancer patient with prior ipsilateral ALNC compared to just 30% of breast surgeons and 10% of breast-care nurses. The majority of breast surgeons and breast-care nurses (70% and 89%, respectively) felt that hand surgery was a relative contra-indication compared to just 41% of hand surgeons. Postoperative lymphoedema was the commonest cited reason for avoiding surgery. The majority of hand surgeons (79%) and nearly two-thirds of breast surgeons (57%) would use a tourniquet during surgery if it was normal practice.

CONCLUSIONS

A review of the published literature does not support the notion that these patients experience increased complications; therefore, we recommend the advice given to breast cancer patients regarding ipsilateral surgery be re-evaluated.     

The top 100 cited articles in urology

Background

We identified and analyzed the characteristics of the 100 most frequently cited articles published between 1965 and 2007 in journals pertaining to urology and related fields.

Methods

We selected 69 of the highest impact urology and sub-specialty journals and 22 of the highest impact general medical and medical research journals from the 2006 edition of Journal Citation Reports: Science edition. We identified the 100 most frequently cited urological articles published in these 91 journals using the Science Citation Index Expanded (1965–present). We reviewed and analyzed the articles.

Results

The top 100 articles were cited a mean of 629 times (range 418–1435) and published between 1965 and 2003, with 89% published after 1979 and 54% published in the 1990s. Fifteen journals were represented, led by The New England Journal of Medicine (30), The Journal of Urology (22) and Lancet (11). Ninety publications originated from North America (81) or the United Kingdom (9). Johns Hopkins University (13), Harvard University (5), Stanford University (5) and University of California, Los Angeles (5) published the most articles. Five urologists were first authors of 2 or more of the articles. Fifty-six articles reported observational studies. Oncology (51) and transplantation (20) were the most commonly represented urological subfields.

Conclusion

These top-cited articles in urology identify topics and authors that contributed to major advances in urology. Observational studies and randomized controlled trials in oncology published in high-impact urological or medical journals constitute the most common type of highly cited publications.     

Los top 100. Revisión de los artículos más citados en cirugía

Introduction

We performed a study of the top 100 most cited articles in the five general surgery journals with the highest impact according to Journal Citation Report.

Role of preoperative carbohydrate loading: a systematic review

INTRODUCTION

Surgical stress in the presence of fasting worsens the catabolic state, causes insulin resistance and may delay recovery. Carbohydrate rich drinks given preoperatively may ameliorate these deleterious effects. A systematic review was undertaken to analyse the effect of preoperative carbohydrate loading on insulin resistance, gastric emptying, gastric acidity, patient wellbeing, immunity and nutrition following surgery.

METHODS

All studies identified through PubMed until September 2011 were included. References were cross-checked to ensure capture of cited pertinent articles.

RESULTS

Overall, 17 randomised controlled trials with a total of 1,445 patients who met the inclusion criteria were identified. Preoperative carbohydrate drinks significantly improved insulin resistance and indices of patient comfort following surgery, especially hunger, thirst, malaise, anxiety and nausea. No definite conclusions could be made regarding preservation of muscle mass. Following ingestion of carbohydrate drinks, no adverse events such as apparent or proven aspiration during or after surgery were reported.

CONCLUSIONS

Administration of oral carbohydrate drinks before surgery is probably safe and may have a positive influence on a wide range of perioperative markers of clinical outcome. Further studies are required to determine its cost effectiveness.     

Altmetric Versus Bibliometric Perspective Regarding Publication Impact and Force

Background

Bibliometric and Altmetric analyses highlight key publications, which have been considered to be the most influential in their field. The hypothesis was that highly cited articles would correlate positively with levels of evidence and Altmetric scores (AS) and rank.

Methods

Surgery as a search term was entered into Thomson Reuter’s Web of Science database to identify all English-language full articles. The 100 most cited articles were analysed by topic, journal, author, year, institution, and AS.

Results

By bibliometric criteria, eligible articles numbered 286,122 and the median (range) citation number was 574 (446–5746). The most cited article (Dindo et al.) classified surgical complications by severity score (5746 citations). Annals of Surgery published most articles and received most citations (26,457). The country and year with most publications were the USA (n?=?50) and 1999 (n?=?11). By Altmetric criteria, the article with the highest AS was by Bigelow et al. (AS?=?53, hypothermia’s role in cardiac surgery); Annals of Surgery published most articles, and the country and year with most publications were USA (n?=?4) and 2007 (n?=?3). Level-1-evidence articles numbered 13, but no correlation was found between evidence level and citation number (SCC 0.094, p?=?0.352) or AS (SCC?=?0.149, p?=?0.244). Median AS was 0 (0–53), and in articles published after the year 2000, AS was associated with citation number (r?=?0.461, p?=?0.001) and citation rate index (r?=?0.455, p?=?0.002). AS was not associated with journal impact factor (r?=?0.160, p?=?0.118).

Conclusion

Bibliometric and Altmetric analyses provide important but different perspectives regarding article impact, which are unrelated to evidence level.

     

The Most Frequently Cited 100 Articles in Liver Transplantation Literature

Introduction

We investigated the liver transplantation literature since 1975 and found the most frequently cited 100 articles and assessed the distribution of authors and journals of these articles.

Laparoscopy During Pregnancy: A Literature Review

Objective:

To review the literature regarding the role of laparoscopy during pregnancy, particularly adnexal mass and non-obstetric surgery, incorporating the results of a series of 9 cases of laparoscopy during pregnancy at our centers.

Materials and Methods:

A Medline search was performed to review the literature, and the reference lists provided by those articles were further explored for citations regarding laparoscopic adnexal surgery, appendectomy, and cholecystectomy. Our series of 9 patients consisted of pregnant patients with adnexal mass or acute abdomen who would otherwise have undergone exploratory laparotomy. Follow-up data for these 9 cases were collected by office visits, inquiry to the primary referring physicians, and telephone calls to the patient.

Results:

The literature search yielded 42 additional cases of operative pelvic laparoscopy and 51 cases of abdominal operative laparoscopy (cholecystectomy and appendectomy). The publications, particularly regarding cholecystectomy, were supportive of the laparoscopic approach during pregnancy. All of the patients in our series had favorable outcomes.

Conclusions:

Advanced operative laparoscopy has been successfully performed for certain indications during pregnancy.     

Treatment preferences for trigger digit by members of the American Association for Hand Surgery

Background

Trigger digit is a common pathology encountered by hand surgeons, but there is a lack of evidence-based guidelines. We investigated the treatment preferences of hand surgeons and explored whether geographic location, type of residency training, or clinical experience is associated with differences in practice.

Methods

An online survey was distributed via email by the American Association for Hand Surgery to 615 members. The survey consisted of 17 questions related to conservative and operative management of trigger digits.

Results

One hundred thirty-nine unique responses were received (22.6 %). Geographic distribution of respondents encompassed the entire USA and was not associated with variations in practice. Of the respondents, 56.8 % were trained in orthopedic surgery while 37.4 % had plastic surgery training. In regards to duration of practice, 8.6 % were in practice for up to 5 years, 29.5 % for 6–15 years, 33.8 % for 16–25 years, and 28.1 % for more than 25 years. Notably, the great majority of respondents preferred corticosteroid injections for initial treatment. Those who were willing to give three or more injections prior to surgery were more likely to be plastic surgeons in practice for 16 years or more. A large minority of surgeons utilized splinting in their conservative management. Orthopedic surgeons were more likely to perform tenolysis during pulley release and more likely to use monitored anesthesia care.

Conclusions

Variation exists between the treatment algorithms of hand surgeons when managing a trigger digit. Some of these differences may be attributable to the type of training or the duration of clinical practice.     

The 50 Most-cited Articles in Orthopaedic Surgery From Mainland China

Background

Citation analysis has been widely used to evaluate the impact of articles in medical and surgical specialties. Although China is the most populous country in the world, and although more than 50,000 orthopaedic surgeons practice there, to our knowledge no formal citation analysis of Chinese orthopaedic articles has been performed.

Questions/purposes

We identified the 50 most-cited orthopaedic articles from mainland China and evaluated these articles in terms of their language of publication, source journals, and topics.

Methods

Science Citation Index Expanded was searched in July 31, 2014 for citations of articles published in 70 selected journals since the inception of the database. The 50 most-cited orthopaedic articles originating in mainland China were identified. Basic information, including title, authors, year of publication, article type, journal in which the work was published, city, institution, number of citations, decade published, and topic or subspecialty of the research were recorded.

Results

The number of citations for the top 50 papers ranged from 181 to 31 (mean, 52). These articles were published between 1981 and 2010. The decade of 2000 to 2009 was the most prolific, with 36 of the top 50 articles published during this time. All articles were written in English and they were published in a total of 16 journals. The journal Spine published the largest number of articles (12), followed by Clinical Orthopaedics and Related Research^® (seven). The journal Lancet had the highest impact factor (39.207 for 2013) among any of the journals that published articles we identified. The top 50 articles originated mainly from Beijing (16) and Shanghai (12), with basic research being the focus of the majority (27 of 50; 54%); the remaining were clinical studies. Bone was the most-investigated topic in basic research; the spine was the most-common topic among the identified clinical studies.

Conclusions

The 50 most-cited articles that we identified should be considered influential, although a large gap remains between mainland China and the global orthopaedic community in terms of citations per article. Nevertheless, insofar as the most-recent decade of our survey generated the most articles in this top-50 list, we would characterize mainland China’s effect on musculoskeletal research as increasing, and as funding increases to programs in mainland China, we anticipate this trend will continue in the future.     

Considerations for Prophylactic Surgery in Asymptomatic Severe Cervical Stenosis: Review Article

Background

Cervical spondylotic myelopathy (CSM) is a devastating pathology that can severely impair quality of life. The symptoms in CSM progress slowly and often do not manifest until they become severe and potentially irreversible. There is a consensus that surgical intervention is warranted in symptomatic patients. The recovery of the neurologic deficit after surgical decompression of the spinal cord varies, and halting the progression of the disease remains the principle aim of surgery.

Questions/Purposes

The aim of this review is to address the key question of whether or not to intervene in cases that have radiographic evidence of significant cervical stenosis yet are asymptomatic or exhibit minimal symptoms?

Methods

The PubMed databases for publications that addressed asymptomatic cervical spondylotic myelopathy were reviewed. The relevant articles were selected after screening all the resulting abstracts. The references of the relevant articles were then reviewed, and cross references with titles discussing CSM were picked up for review.

Results

The search identified 14 papers which were reviewed. Seven articles were found to be relevant to the subject in question. Going through the references of the relevant articles, three articles were found to be directly related to the topic in study.

Conclusion

There is paucity of evidence to support for or against surgery in the setting of asymptomatic cervical spondylotic myelopathy despite radiographic evidence of severe stenosis. Patient factors such as age, level of activity, and risk of injury should be considered in formulating a management plan. Moreover, the patient should play an integral role in the process of decision making.

Electronic supplementary material

The online version of this article (doi:10.1007/s11420-014-9426-4) contains supplementary material, which is available to authorized users.     

Absorbable or non-absorbable sutures? A prospective,randomised evaluation of aesthetic outcomes in patients undergoing elective day-case hand and wrist surgery

INTRODUCTION

We prospectively evaluated aesthetic outcomes in a group of randomised patients who underwent elective day-case hand and wrist surgery using either absorbable or non-absorbable sutures.

PATIENTS AND METHODS

A cohort of 100 adult patients were randomised using sealed envelopes to receive either absorbable or non-absorbable sutures for their wound closure. Clinical review was carried out at 6 weeks. A postal questionnaire was sent to all patients 3 months following surgery comprising a visual analogue scale (VAS) for wound satisfaction, a validated 6-point patient scar assessment tool and the shortened version of the disabilities of the arm, shoulder and hand questionnaire (QuickDASH).

RESULTS

From the postal questionnaire, 70 responses were received. There was no statistically significant difference between the two groups in terms of VAS, patient scar assessment tool and quick DASH.

CONCLUSIONS

For elective day-case hand and wrist surgery, either suture material can be used confidently with respect to overall aesthetic appearance in such patients.     

Role of Evidence-Based Reviews in Surgery in teaching critical appraisal skills and in journal clubs

Background

Evidence-Based Reviews in Surgery (EBRS) is a program developed to teach critical appraisal skills to general surgeons and residents. The purpose of this study was to assess the use of EBRS by general surgery residents across Canada and to assess residents’ opinions regarding EBRS and journal clubs.

Methods

We surveyed postgraduate year 2–5 residents from 15 general surgery programs. Data are presented as percentages and means.

Results

A total of 231 residents (58%, mean 56% per program, range 0%–100%) responded: 172 (75%) residents indicated that they know about EBRS and that it is used in their programs. More than 75% of residents who use EBRS agreed or strongly agreed that the EBRS clinical and methodological articles and reviews are relevant. Only 55 residents (24%) indicated that they used EBRS online. Most residents (198 [86%]) attend journal clubs. The most common format is a mandatory meeting held at a special time every month with faculty members with epidemiological and clinical expertise. Residents stated that EBRS articles were used exclusively (13%) or in conjunction with other articles (57%) in their journal clubs. Most respondents (176 of 193 [91%]) stated that journal clubs are very or somewhat valuable to their education.

Conclusion

The EBRS program is widely used among general surgery residents across Canada. Although most residents who use EBRS rate it highly, a large proportion are unaware of EBRS online features. Thus, future efforts to increase awareness of EBRS online features and increase its accessibility are required.