The 100 Most Impactful Papers in Hand and Upper-Extremity Surgery Over the Last 25 Years: A Bibliometric Analysis

Abstract

There is no financial information to disclose. Despite growth in hand/upper-extremity investigation, truly impactful studies have not been thoroughly identified. While previous studies were limited in scope of subspecialty and journals, this study sought to identify (by citations) and characterize the most impactful papers in hand/upper extremity over the last 25 years. The top 1,000 cited studies published between 1992 and 2018 related to the hand and/or upper extremity were identified with Thomson ISI Web of Science. Studies were organized in descending order by number of citations, and the title and abstract of each study were screened for relevance. Following exclusion of unrelated studies, the top 100 articles by number of citations were identified and reviewed to identify study type, institutional origin, level of evidence, and journal impact factor. Among the top 100 studies, all were cited at least 100 times, and the mean number of authors and citations were 4.51 and 169.4, respectively. The top 5 study types were case series (n = 52), randomized controlled trial (n = 17), prospective cohort (n = 16), retrospective cohort (n = 8), and basic science (n = 4). The topics covered were mostly commonly related to shoulder (n = 34), wrist/forearm (n = 21), hand (n = 17), and elbow (n = 14). Among shoulder studies, rotator cuff injuries (n = 18) were most frequent, while distal radius fractures (n = 12) were most common among wrist/forearm studies and nerve/nerve repair (n = 10) among hand studies. Most studies were published from institutions originating in the United States (n = 63). The journal that published the most among the top 100 cited was the Journal of Hand Surgery–American Volume (J Hand Surg Am; n = 33), with 5,092 citations 3 among the top 10 (Table 20-1). Mean journal impact factor was 3.29. The majority of studies were of level IV (n = 51) and level II (n = 16) evidence (Figure 20-1). However, the number of level I studies has increased since 1992 (3 in 1992–2006 vs 5 in 2007–2011). The impact of more recent studies is greater, with mean citations per year in 2011 at 82.7/y, compared with 16.1/y in 1992 (R2 = 0.54). •Despite the shorter time frame more recent studies have for impact, mean citations per year have progressively increased over the past quarter century.•The majority of the top 100 articles were published in J Hand Surg Am, were case series, and focused on the shoulder.•While the number of level I studies has increased, the majority were level IV or II, retrospective, and non-randomized studies, emphasizing the call for higher-quality, prospective, randomized trials to bolster our evidence-based practice.Table 20-1The top 10 most cited hand/upper-extremity studies among the top 100 studies, by number of citationsRankTitleFirst AuthorInstitutionJournalYearCitationsStudy Type1The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tearsGalatz LMWashington UniversityJBJS Am2004863Case Series2Treatment of chronic elbow tendinosis with buffered platelet-rich plasmaMishra AStanfordAJSM2006412Prospective Cohort3Reliability and validity testing of the Michigan Hand Outcomes QuestionnaireChung KCUniversity of MichiganJHS Am1998388Case Series4Neer Award 2005: The Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplastyBoileau PUniversity of NiceJSES2006355Prospective Cohort5The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: longitudinal construct validity and measuring self-rated health change after surgeryGummesson CLund UniversityBMC Musculoskeletal Disord2003336Case Series6Functional and anatomical results after rotator cuff repairGazielly DFClinique du DiaconatCORR1994330Case Series7The reverse shoulder prosthesis for glenohumeral arthritis associated with severe rotator cuff deficiency: a minimum 2-year follow-up study of 60 patientsFrankle MFlorida Orthopaedic InstituteJBJS Am2005325Case Series8Fatty infiltration and atrophy of the rotator cuff do not improve after rotator cuff repair and correlate with poor functional outcomeGladstone JNMount Sinai Medical CenterAJSM2007320Prospective Cohort9Endoscopic release of the carpal tunnel: a randomized prospective multicenter studyAgee JMHand Biomechanics LaboratoryJHS Am1992293Randomized Control Trial10Factors affecting functional outcome of displaced intra-articular distal radius fracturesTrumble TEUniversity of WashingtonJHS Am1994292Case Series Open table in a new tab