Subspecialty Variation in Academic Citations of Orthopedic Surgery Publications

BackgroundThe objective of this study was to assess the variation in academic citation and social media mentions across orthopedic subspecialties in general orthopedic surgery journals.MethodsAn internet-based study was performed of 666 articles from four orthopedic journals published from January 2018 to February 2019. Each publication was categorized by its subspecialty within orthopedics: arthroplasty, hand and upper extremity, foot and ankle, orthopedic oncology, pediatric orthopedics, shoulder, spine, sports medicine, orthopedic trauma, basic science, and miscellaneous. For each publication, academic citations were quantified using Google Scholar and Web of Science, and social media mentions were quantified using Twitter. Comparisons of continuous data among various subspecialties were performed using analysis of variance.ResultsThe average number of citations per publication was 7.4 ± 9.0 on Google Scholar, 4.5 ± 5.3 on Web of Science, and 2.8 ± 8.7 on Twitter. The number of academic citations differed significantly by subspecialty on Google Scholar (p < 0.001) and Web of Science (p < 0.001). There was no difference in social media mentions on Twitter by subspecialty (p = 0.8). The most highly cited subspecialties, adjusted for number of publications, were arthroplasty, orthopedic oncology, and sports medicine, while the least highly cited subspecialties were hand and upper extremity, pediatric orthopedics, and orthopedic basic science.ConclusionsThere is significant baseline variation in the citation of orthopedic publications among various subspecialties. Our findings argue against the use of a uniform threshold to gauge scholarly success in orthopedic surgery. The variation in citation of orthopedic publications across subspecialties support the use of subspecialty-specific benchmarks to gauge academic productivity.     

Trends in Foot and Ankle Studies Published in High-Impact General Medical Journals: A Systematic Review

The foot and ankle surgery literature lacks an analysis of studies published in general medical journals. Studies published in general medical journals have high visibility and significant impact on decision making by medical practitioners and health care policy makers. Knowledge of the subject matter and methodologic characteristics of foot and ankle publications being read by general medical practitioners and the lay public is important to the practicing foot and ankle surgeon. A systematic review of foot and ankle studies published from 2000 to 2017 in 5 high-impact general medical journals was undertaken. Data extracted included study topic, study design, study demographics, and methodologic characteristics of randomized controlled trials (RCTs). There were 47 foot and ankle studies published in the selected medical journals examined during the study time period. Most common topics were diabetic foot ulcers (n = 25 [53.2%]), plantar fasciitis (n = 6 [12.8%]), and Achilles tendinopathy (n = 5 [10.6%]). The most common study types were reviews (n = 24 [51.1%]), RCTs (n = 12 [25.4%], and prospective studies (n = 6 [12.8%]). Of the published RCTs, the most common journal of publication was the Journal of the American Medical Association (n = 7 [58.3%]). The median number of citations for RCTs published before 2016 was 242.5. Of the small number of RCTs that compared operative with nonoperative treatment, the majority supported nonoperative management (n = 3 [75%]). Diabetic foot ulcers, plantar fasciitis, and Achilles tendinopathy are the most commonly published foot and ankle topics in general medical journals.     

Peer reviewing in foot and ankle surgery: is there a limit to scientific altruism?

IntroductionComplex foot and ankle trauma surgery is a super-specialization of orthopedic trauma surgery. This topic is gaining in interest, both clinically and in research. The peer review process is the cornerstone of the current scientific model of evaluation of research papers. The burden of peer review activity in foot and ankle trauma surgery is currently unknown.Material and methodA comprehensive Microsoft Outlook® analysis of over seven years’ worth of review invites from one surgical Foot & Ankle specialist working at a Level-1 trauma center was evaluated. The topic of each paper was recorded. Whether or not the journal was specifically foot ankle, orthopedic, general medicine or predatory of origin was noted. In addition, it was recorded if the journal was indexed in Pubmed, Medline, or Scopus. The topic of the paper was scored as being foot and ankle related, and more specifically foot and ankle trauma related. Review of revisions were scored as invites as well.ResultsFrom January 2013 to December 2019 a total of 467 review invites were received. The number of peer review invitations rose from 14 in 2013 to 127 in 2019. The percentage of foot and ankle specific journals was 27.4%. The number of requests from non-indexed (predatory) journals rose from 3.7% in 2014 to 36.2% in 2019, with a decrease in article topics related to the authors subspecialty. The annual absolute number of performed reviews stayed approximately the same throughout the study period (34 on average in the last 5 years).ConclusionThe number of review requests in foot and ankle surgery has increased about 5-fold over the 5 year period evaluated. There is a need for more reviewers to spread the burden. Therefore, foot and ankle specialists who are prepared to publish, should also be prepared to provide peer reviews to maintain a high level of quality in foot and ankle research.     

Scholarly Productivity Among Academic Foot and Ankle Surgeons Affiliated With US Podiatric Medicine and Surgery Residency and Fellowship Training Programs

Foot and ankle surgeons practicing within academic medicine balance clinical or surgical training, course instruction, administrative duties, and research. Along with clinical skills and patient volume, promotion within academia often relies on scholarly productivity. Previous research across specialties described this productivity using variables including publications, citations, and the h-index, a scale that quantifies the productivity and citation impact of published works, among academic ranks. As no studies examine the scholarly impact of foot and ankle surgeons with academic appointments, this study aimed to analyze the productivity and gender differences present in this specialty. A systematic review of academic-affiliated foot and ankle surgery residencies and fellowships was performed; and faculty members were screened for sex, academic rank, publication history, citations, h-index, and years in practice. Among 234 programs reviewed, 44 programs allowed for the analysis of 106 practitioners with an academic rank eligible for analysis. Overall, 78.3% of practitioners were male with the most common rank being assistant professor. Men published more documents and maintained higher citations as well as longer years in practice, and this was significant (p < .05). A significant difference was exhibited among all academic ranks (p ≤ .001). Multivariate regression revealed the publication history and years in practice are strongly correlated with the h-index of providers (p ≤ .001). Foot and ankle surgeons practicing in an academic setting may use the results of this study to gauge their productivity and identify benchmarks that similar providers have met at varying academic ranks.     

Thromboprophylaxis across orthopaedic surgery: Bibliometric analysis of the most cited articles

PurposeOne of the most common adverse events after orthopaedic surgery, with a potential for subsequent serious morbidity and mortality is venous thromboembolism (VTE). Bibliometric analysis has been performed regarding many topics and across orthopaedics. As DVT prophylaxis is a major component of both orthopaedic surgery considerations and research, a bibliometric analysis in this area would prove beneficial in not only in understanding the research done in the field thus far, but would also direct future research efforts.MethodsThe Web of Science (WoS) database from the Institute of Scientific Information (ISI) was used to compile articles for bibliometric analysis using Boolean search: ((Orthopaedic1 OR Orthopaedic1) AND (thromboprophylaxis OR Thromboembolism OR Deep vein thrombosis OR thrombus OR embolism OR anticoagulation OR Embolus OR prophylaxis)).ResultsThe Top 100 cited articles included in the final list generated a total of 21,099 citations. The highest cited article was Prevention of venous thromboembolism by Geerts et al. published in Chest, which had a total of 2802 on WoS, and a calculated citation density of 215.54 of citations/years since publication. Comparing the overall citation against the year of publication there was a slight positive trend favoring more recent publications (R-value: 0.142; adjusted R-squared: 0.01; p = 0.16). Analysis of an articles Level of Evidence (LOE), 17 were grade with a level of I.ConclusionsOrthopaedic thromboprophylaxis is an ever-changing field that is at the forefront of orthopaedic literature. The significant trend favoring high quality research within orthopaedic thromboprophylaxis demonstrates the importance of this topic and there was a need for a guide to best understand the evolution of DVT prophylaxis.     

Bibliometric analysis of the top 50 most cited publications of the Journal of Clinical Orthopaedics and Trauma

BackgroundThe Journal of Clinical Orthopaedics and Trauma (JCOT) is one of the top three orthopaedic journals from India. We set out to analyse the top 50 cited articles from JCOT since indexing in PubMed and Scopus.MethodsWe looked into the bibliometrics of the top 50 cited articles and compared citations from PubMed and Scopus, and depicted outputs from VOS viewer analysis on co-authorship and keywords.ResultsTotal citations for top-cited articles were 1076 in numbers, with a maximum of 103.2016 and 2018 were the most productive years. The major contribution was from India with 74%, followed by the USA. New Delhi published maximally at 72%. Clinical topics and narrative reviews were the most common types of studies. Trauma and Adult reconstruction was the most common sub-specialities, and Level 4 was the most frequent level of study. The basic science and COVID-19 related articles received the maximum citations. The authors from Indraprastha Apollo Hospitals published the maximum number of top-50 cited articles in the JCOT.ConclusionsThere is a steady increase in the number of publications in the JCOT, with an increasing number of citation counts. Both the Indian and foreign authors have been publishing in this journal at a comparative rate. Although the citation counts in Scopus are more than those in PubMed for given articles, more than 80% of articles are listed in both databases as top 50 cited articles. The majority of top-cited articles belonged to trauma and adult reconstruction, level III studies, and narrative reviews.     

Last five years audit of Journal of Clinical Orthopaedics and Trauma (JCOT) - A scientometric analysis

BackgroundWe have studied the growth of Journal of Clinical Orthopaedics and Trauma (JCOT), the official journal of the Delhi Orthopaedic Association indexed in PubMed, Scopus and Embase, along with an analysis of citation trends and levels of evidence of published articles in the last five years.MethodsSCOPUS and PubMed databases (2015–19) were used to extract publication-related data for the last five years. The official website of the journal was also used to retrieve issue-specific data. An audit of recent publications in the JCOT was conducted focusing on number of issues and publications(year wise), types of articles published, review speed, level of evidence of publications, types of publication(speciality wise), number of publications in PubMed and SCOPUS, number of citations(year wise), national and international authorship and the Cite Scores.ResultsThe submissions were increased by 2.8 times and the citations rocketed to 16.6 times in 2019, compared to 2015. A total of 890 papers were there and the journal was cited 1702 times in the last five years. More articles with higher levels of evidence papers are now being published.ConclusionThere has been a significant increase in the numbers of submissions, publications, citations, Cite Score, h-index and contribution by the International authors. Its Editorial efficiency has also been outstanding with timely reviews and editorial decisions. The JCOT has become increasingly internationally relevant in the last five years, in the orthopaedic community. However, JCOT needs to publish more papers with a higher level of evidence like Systematic reviews, Meta-analyses, Randomized Controlled Trials and should only publish top-class lower hierarchy papers (like Case reports, Case-controlled and Retrospective studies).     

The first ten years of The Foot: a retrospective analysis of publication patterns, 1991–2000

Background: The Foot commenced publication in 1991 to provide an international forum for clinical foot and ankle research. As the journal has just reached the end of its first decade, it is timely to look back and review publication patterns over this time.Methods: A retrospective analysis of every paper published in The Foot between 1991 and 2000 was undertaken. Articles were evaluated to determine the article type (i.e.: original research, literature review, case report, etc), the topic area, the country of origin of the primary author and the professional background of the primary author.Results: The majority of papers published have been original research (44%), followed by case reports (32%) and literature reviews (18%). The topic area of papers has been diverse, covering 23 different categories, with most papers pertaining to foot surgery (27%). Authors from 27 different countries have published in the journal, with most papers submitted by authors from the UK (67%). The most frequent publishers in the journal were orthopaedic surgeons (63%), followed by podiatrists (25%). Between 1991 and 2000, there has been a steady increase in the number of papers published by podiatrists, and a small increase in the number of papers published by authors outside the UK.Conclusions: These results confirm the status of The Foot as a truly international, multidisciplinary forum for the publication of clinical foot and ankle research.     

Characteristics and research trends of 50 most-cited hallux rigidus papers

BackgroundThe bibliometric studies in the field of orthopaedics have gained popularity since they can determine the characteristics and research trends of most influential papers in specific subjects. This study aimed to evaluate the 50 most-cited articles related to hallux rigidus, and analyze possible factors associated with increased citation counts.MethodsThe available literature about hallux rigidus on Web of Science database until January 2021 were analyzed and the 50 most-cited articles were determined. The characteristics of the papers were documented and analyzed for any relationship or correlation with total citation or citation per year (citation density) values.ResultsThe average citation number and citation density were 52.8 (range: 26–243) and 3 (range: 0.8–12.8), respectively. The average author number was 3.4, while the average institution number was 1.9. The USA had the highest number of articles with 29. Twenty-six papers were case-series, only 3 studies had level 1 and only 2 had level 2 evidence. The highest number of articles were published in Foot and Ankle International with 22 papers. Forty papers were clinical studies while 10 were reviews. Five studies were multicentric.ConclusionThis study provided the general characteristic and research trends of 50 most influential hallux rigidus papers. The number of institutions and references were positively correlated with citation density, indicating a higher chance of getting cited for papers with collaborations from different institutions and papers using more references from other works. Publication year was also positively correlated with citation density, indicating the better performance of more recent articles.Level of Clinical EvidenceLevel 3     

The top 100 cited of injury-international journal of the care of the injured: A bibliometric analysis

BackgroundWith nearly 50 years’ of development, Injury has become one of the leading journals in its specialty. The aim of this article is to identify, analyze the characteristics of the 100 most cited articles published by the journal to date.MethodWe searched the Thomson Reuters Web of Science Core Collection for citations of all articles published in Injury since its launch. For the Top 100 most frequently cited articles, title, author name, number of authors, publishing date, citation number, country of origin, institution, pages, number of reference, type of article, study topic, study design, funding source, and level of evidence of each clinical article were recorded and analyzed.ResultsOnly 50 self-citations were found in 12436 total citations of the top100 articles, fifty-four articles exceeded 100 citations. Total citations of the Top 100 articles ranged from 77 to 599. The Top 100 articles were published between 1973 and 2012, the mean authorship and institution number per paper was 3.92 and 1.84 respectively. The mean page number was 8.26 and the mean reference number was 45.2. England, Germany and Switzerland ranked the top three countries of origin. Among the T100 articles, there were 50 clinical studies, 5 basic researches, and 45 reviews. The most common study type was case series, and most common topics were bone reconstruction, trauma and bone fracture. The most common level of evidence was level Ⅳ.ConclusionsThis study may help researchers to find out the important information on the classic articles and provides useful insights for the authors who want to publish their research in Injury.     

Citation analysis of the most influential articles on traumatic spinal cord injury

Objective: We conducted a citation analysis in order to catalog and pay tribute to the 100 most influential clinical research articles in traumatic spinal cord injury.

Design: The Thomson Reuters Web of Science was searched in a two-step process without time period limitations. Review articles were excluded. In the first stage of data extraction, a Boolean query was used to identify the top 100 most cited clinical papers on traumatic spinal cord injury. One hundred and seven keywords were manually chosen and extracted from titles and abstracts. A second Boolean query used these keywords to broaden search results. The top 100 articles from this second stage search comprised the final list.

Outcome Measures: For each article, measures evaluated were number of citations, average number of citations per year, time elapsed before first citation, and time elapsed until the year in which each article received its respective highest number of citations in a one-year period.

Results: 119,991 articles were found in the second stage search. The top 100 most cited articles meeting inclusion criteria were identified within the first 2,104 results. Archives of Physical Medicine and Rehabilitation was the most represented journal, with 20 of the top 100 articles. The top 100 list averaged 255 citations per article. The most highly cited article was the NASCIS 2 trial by Bracken et al., cited 1500 times, which investigated the efficacy of methylprednisolone or naloxone for spinal cord injury.

Conclusion: Clinical research in traumatic spinal cord injury has grown over time, expanding to encompass rehabilitation and experimental therapies in addition to acute management trials. The list may serve as an archive and reference for further studies in this field.     

Elective foot and ankle surgery; activity and perioperative complications in Queensland public hospitals,Australia

ObjectiveTo conduct an audit of elective foot and ankle surgery in Queensland public hospitals and to compare the frequency of these procedures performed to other states and territories of Australia.MethodsICD-10-AM data was used to extract elective foot and ankle procedures from the Data Services Unit of Queensland Health, and the Australian Institute of Health and Welfare between the years of 2000 and 2004.ResultsDuring the 4-year audit period 3846 primary procedures were performed during the 4-year period with a complication rate of 2.2% during the hospital admission period. Mean length of stay was 1.7 days. Post-operative infection rates were 0.26%. With the exception of Tasmania and the Northern Territory, Queensland performs the least number of elective foot and ankle procedures per capita per year in Australia.ConclusionsThis is the first reported audit of elective foot and ankle surgery for Queensland public hospitals. Complication rates cannot be directly compared to the literature as this data could only capture complications within hospital admission period. Fewer elective foot and ankle procedures were performed in Queensland public hospitals compared to all other mainland states of Australia during the data collection period.     

High-impact articles in hand surgery

Background

There have been few attempts to identify classic papers within the hand surgery literature. This study used citation analysis to identify and characterize the top 50 highly cited hand surgery articles published in six peer-reviewed journals.

Methods

The 50 most highly cited hand surgery articles were identified in the Journal of Bone and Joint Surgery (JBJS) American, JBJS British, Plastic and Reconstructive Surgery, Journal of Hand Surgery (JHS) American, JHS British/European, and Hand. Articles were evaluated for citations per year, surgical/anatomical topic, and type of study. Clinical studies were further sub-categorized by level of evidence. The distribution of topics was compared with all indexed hand surgery articles. The educational relevance was assessed via comparison with lists of “classic” papers.

Results

The most common subjects were distal radius fracture, carpal tunnel syndrome, and flexor tendon repair. There was moderate correlation between the distribution of these topics and all indexed hand surgery articles (rho = 0.71). There were 31 clinical studies, of which 16 were therapeutic, ten were prognostic, and five were diagnostic. These articles assessed the outcomes of an intervention, described an anatomical/functional observation, introduced an innovation, presented a discovery/classification, or validated a questionnaire. There were only three randomized trials. Using citations per year to control for the influence of time since publication, 36 articles were consistently highly cited. Twenty-three articles were on Stern’s Selected Readings in Hand Surgery, considered important in education.

Conclusions

The top 50 highly cited articles in hand surgery reflect the most common clinical, scientific, and educational efforts of the field.     

The 50 Highest Cited Papers in Hip and Knee Arthroplasty

The 50 highest cited articles related to hip and knee arthroplasty were searched in Thomson ISI Web of Science®. The 50 highest cited articles had up to 2495 citations. The top 10 papers according to absolute number were cited 580 times at least. Most papers were published in the Journal of Bone and Joint Surgery American Volume (n = 22). Eight countries contributed to the list with most contributions from the United States (n = 30). The majority of papers were published since 1990 (n = 27). Studies focusing on the clinical outcome of hip arthroplasty dominate the literature in orthopedic arthroplasty in respect to absolute citations numbers. In the last decade however, papers on perioperative management have been published that show a high citation frequency.     

Pneumatic tourniquet use in foot and ankle surgery – Is padding necessary?

BackgroundThe majority of foot and ankle surgery is carried out in a bloodless field achieved by the use of a pneumatic tourniquet. The risks of tourniquet use may be divided into those resulting from direct mechanical pressure from the cuff and those secondary to prolonged limb ischaemia.Current peri-operative guidelines advise the use of padding beneath the cuff, in particular to reduce skin complication.ObjectivesTo assess the complication rate of tourniquet use when the cuff is applied directly to the skin.MethodPatients undergoing foot and ankle surgery under tourniquet control without use of padding were assessed pre and post operatively for soft tissue complication, neurological deficit and post-tourniquet syndrome.ResultsWe recorded findings for 97 patients, 47 thigh and 50 ankle tourniquets. We found a complication rate of 0%. There were no cases of skin blistering, abrasion, bruising, laceration or burn.ConclusionsThese findings are contrary to published RCTs supporting the use of padding. Our study demonstrates the safe use of pneumatic tourniquets without padding in foot and ankle surgery.     

Top 100. Revisión de los artículos más citados sobre cirugía laparoscópica del páncreas

IntroductionThe number of citations is considered as an indirect indicator of the merit of an article, journal or researcher, although it is not an infallible method to determine scientific quality. Our goal is to determine the characteristics of the articles most cited about pancreas and laparoscopy.MethodsWe performed a search of all articles published in any journal about pancreas and laparoscopy until September 2019 and selected the 100 most cited papers. We recorded number of citations, journal, year of publication, quartil, impact factor, institution, country, authors type of paper, type of surgery, topic and area.ResultsThe top 100 citations account 10,970 citations in total. The journal with the most articles is Surgical Endoscopy and 2007 is the year with the highest number of articles in the top 100 citations. The percentage of publications from America and Europe are similar.Case series is the most frequently paper, outcomes/morbidity is the most frequently discussed topic, and distal pancreatectomy is the most frequently type of surgery.ConclusionsThis bibliometric study on pancreas and laparoscopy is conditioned by the time factor, since laparoscopy has arrived later at pancreatic surgery, probably due to the morbidity and mortality associated with pancreatic surgery and the need for a high specialization in this field. The literature is recent and scarce. More and better-quality studies are needed in this field.     

The Top 100 Most-Cited Articles on Hallux Valgus

BackgroundTo perform the citation and content analysis of 100 articles on Hallux valgus from the most cited to the least.Materials and methodsArticles published on Hallux valgus between 1980 and 2020 were analyzed by making use of the Web of Science database. Articles were ranked from most cited to the least. Content analysis of all articles was also carried out. Original research articles, reviews, and clinical trials were included in the study whereas case reports were excluded from the study.ResultsThe total number of citations of the 100 most-cited articles was 7,697. The most-cited article was ‘Prevalence of hallux valgus in the general population; systematic review and meta-analysis’ published by Sheere Nix in Journal of Foot and Ankle Research in 2010. The country where the articles were mostly produced was USA (n = 46). The most interesting issue was the osteotomy techniques and changes in Hallux valgus surgery.ConclusionThe treatment of the Hallux valgus disease is still discussed today. Citation analyses have shown that surgical developments related to HV surgery still attract attention, and this information will be updated continuously in line with the increasing number of articles.