Trends in the most cited articles in shoulder surgery, 1900–2019

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BackgroundOur purpose was to identify the 100 most cited articles in the shoulder surgery literature published in past decade and to compare them with the 100 most cited “classic” shoulder surgery articles to identify trends in the topics of shoulder research. MethodsUsing the term “shoulder,” we searched the Clarivate Analytics’ Web of Science Core Collection database for 2 periods: 2010 through 2019 (“contemporary group,” n = 12,394) and 1900 through 2009 (“classic group,” n = 8790). We used the database sort function to order articles by number of citations. Titles, abstracts, and, when necessary, full text were screened to determine relevance to orthopedic shoulder topics until the 100 most cited articles were determined for each group. We analyzed the following article characteristics: title, author(s), publication year, journal, geographic origin, article type (clinical vs basic research), study design, and level of evidence (for clinical articles). P < .05 was considered significant. ResultsThe 3 journals with the most articles in the contemporary group were the American Journal of Sports Medicine (AJSM) (28%), the Journal of Shoulder and Elbow Surgery (JSES) (28%), and the Journal of Bone and Joint Surgery, American volume (JBJS Am) (23%). The top 3 journals in the classic group were JBJS Am (45%), AJSM (16%), and JSES (15%). The 3 most frequent topics in the contemporary group were rotator cuff tear (43%), instability (14%), and fractures (10%); those in the classic group were pathoanatomy (29%), rotator cuff (28%), and instability (17%). Compared with the classic group, the contemporary group had more articles on outcomes of common shoulder procedures, including rotator cuff repair (25% vs. 17%), arthroplasty (21% vs. 15%), arthroscopy (17% vs. 11%), reverse shoulder arthroplasty (13% vs. 7%), and the Latarjet procedure (7% vs. 2%). More articles reporting complications were found in the contemporary (9%) than in the classic (2%) group (P = .03). The contemporary group contained articles on topics not found in the classic group, such as platelet-rich plasma (8%), scaffolds (3%), infection (3%), Cutibacterium acnes (2%), stem cells (2%), superior capsular reconstruction (2%), bony increased offset reversed shoulder arthroplasty (2%), opioid issues (1%), and tendon transfer (1%). ConclusionThe most cited studies from 1900 to 2009 and 2010 to 2019 reported on the rotator cuff and shoulder instability. The most cited articles from 2010 to 2019 reflect the development of shoulder arthroscopy, shoulder arthroplasty, treatment of surgical complications, and augmentation or biologic interventions for rotator cuff repair. Level of evidenceLevel IV; Review Article