Global Orthopaedics

Abstract

Technological advances have shrunk the orthopaedic world. Today, more than ever before, there is a need to consider orthopaedics as an international specialty, with research being accomplished in and reported from every part of the globe. Information about new scientific findings and advances in patient care now can readily reach nearly every country and region. Over the past few years, The Journal of Bone and Joint Surgery has received more than half of its manuscript submissions from outside North America, yet it had no international members of its editorial board. In addition, the percentage of reviewers from outside North America has been small. The Journal has now taken important initial steps to begin to remedy the lack of representatives of the global orthopaedic community on our editorial board. Six new members of the editorial board from outside North America have been added. This group of international deputy editors represents not only multiple regions but multiple subspecialties. Plans are in place to add three more international deputy editors each year in 2012 and 2013. Until recently, the majority of the scientific reports from outside North America emanated from Europe, Scandinavia, and Japan. A large number of randomized clinical trials now submitted to The Journal originate in countries with national health systems, enabling patient-tracking to be done more easily than in the United States. More recently, as the economies of countries such as China, South Korea, Brazil, and India have developed, there has been a parallel upward growth in the amount of medical research being accomplished and a marked increase in submissions of scientific reports from these regions to The Journal. We are fortunate that The Journal attracts high-quality submissions from all parts of the world. The Journal and our readers are benefitting from this uptick in research reports submitted to us from outside North America. A simple example relates to information gleaned from the total joint arthroplasty registries that have been established in many countries worldwide. Similar efforts have lagged in the United States, where total joint arthroplasty registries are just now in their early stages. The data from these total joint arthroplasty registries from multiple countries have led to improved patient care not only in the country of the registry but globally, including in arthroplasty practices in the United States. A recent supplement published in JBJS1 addressed several topics related to the establishment of an International Consortium of Orthopaedic Registries (ICOR). By establishing large multinational joint registries and obtaining longitudinal follow-up data, it is expected that small to moderate clinically important differences in patient outcomes between the various arthroplasty devices used can be detected in a way not possible today. An additional example of the benefit that we derive from international research reports is the work that is done on orthopaedic disorders that are found commonly in developing countries and much less often in developed countries, such as tuberculosis involving the musculoskeletal system. With immigration active throughout the world, orthopaedists in developed countries will see conditions that they have rarely seen previously and the recommendations for treatment that come out of developing countries will allow us to establish earlier diagnosis of these uncommon conditions and provide better patient care. In addition, trauma is omnipresent in all countries and has been identified as a major factor in health-care costs in both developed and developing countries. Research in the world of trauma can have an impact on patient care regardless of the region in which the trauma occurs. The mission statement of The Journal is “To provide and disseminate worldwide the highest quality information about the musculoskeletal system.” The continuing commitment of The Journal to publish high-quality articles from around the world is important in fulfilling this global mission.