American Journal Of Sports Medicine Research Articles

Analysis of Hip Preservation Questions on the Orthopaedic In-Training Examination Over the Past 20 Years.

The orthopaedic in-training examination (OITE) is a 275-question test for orthopaedic residents administered annually. As the field of orthopaedics changes, the OITE evolves its content. The incidence of hip preservation-related procedures has increased substantially over the past decade; nonetheless, an analysis of the trends of hip preservation questions on the OITE has not yet been performed. The purpose of the study was to evaluate the number and type of questions on the OITE related to hip preservation to determine whether trends over time paralleled the increases in hip-related care in clinical practice. It was hypothesized that the frequency of hip preservation questions on the OITE would increase with time. Cross-sectional study. Each OITE between 2002 and 2021 was reviewed for questions related to hip preservation. The types of questions included under "hip preservation" were those related to femoroacetabular impingement (FAI), athletic soft tissue injuries of the hip, acetabular labral tears, hip arthroscopy, and surgical management of adult hip dysplasia-excluding arthroplasty. Questions were quantified and categorized by topic, taxonomy level, associated imaging, and cited sources. There were 30 hip preservation-related questions between 2002 and 2021. Of these, 77% occurred within the past 10 years. Also, 14 questions (47%) had associated images in the question stem-the most common being radiographs (n = 8 questions). The most commonly tested subcategories were FAI (n = 11 questions [37%]), athletic injuries (n = 7 questions [23%]), and anatomy (n = 7 questions [23%]). Over the last 10 years, 97.9% of citations were from journal articles-the most common being the Journal of the American Academy of Orthopaedic Surgeons, Clinical Orthopedics and Related Research, and the American Journal of Sports Medicine. The frequency of hip preservation-related questions on the OITE has increased with time, reflecting trends in clinical practice.

Italian research on anterior cruciate ligament: a bibliometric analysis.

This study analysed thetrend of publications on anterior cruciate ligament(ACL) in Italy. It was hypothesised that publications on this topic have quickly increased in recent years due to increased knowledge of both clinical and radiological pathology. PubMed and Scopus were accessed on 29/11/2023. This retrieved 838 articles from PubMed and 1050 from Scopus. We analysed the top 10 authors, and journals in publication numbers, citation numbers, and citations per year. We have also looked at the top 10 institutions publishing on anterior cruciate ligament from Scopus as PubMed does not give this information in the output. Data mining was performed using the Orange software, Mac version 3.32.0 ( https://orangedatamining.com/ ) from the titles of all articles. A word cloud analysis of titles, authors, journals and universities was performed. The peak of citations was in 2017 with 1529, whilst the peak of publications was in 2019 with 59 articles published. Analysing the number of publications and citations for the journal, the most impacted journal is Knee Surgery, Sports Traumatology, Arthroscopy with 5472 citations and 183 articles, followed by The American Journal of Sports Medicine, with 2722 citations and 56 articles and Arthroscopy with 1990 citations and 62 articles. Considering also international collaborations, the most cited author is Della Villa F. in 2020 with 43.67 citationsper year.The Italian author with the major number of publications is Zaffagnini S. with 39 articles, whilst the author with the higher number of citations is Aglietti P. with 1612 citations. ACL reconstruction has gained growing interest amongst the scientific community. Publications and citations presented a rising trend, the majority of the highly cited papers were contributed by few centres, and clinical trials were the most cited study designs. The long-term outcomes of ACL lesions have attracted interest. The authors hypothesised that shortly there will be an increase in articles analysing the results of ACL revisions, the use of lateral extra-articular tenodesis, and meniscus transplants. Cross-Sectional Study.

Effective Use of Twitter by Orthopaedic Sports Medicine Journals Can Result in Increased Impact Factor

PurposeThe purpose of this study was to determine if activity on Twitter was corelated with increasing impact factor (IF) among six orthopaedic sports medicine journals. MethodsTwitonomy software was used to collect account activity for the American Journal of Sports Medicine, The Journal of Arthroscopic and Related Surgery, Knee Surgery, Sports Traumatology, Arthroscopy, Journal of Shoulder and Elbow Surgery, Orthopaedic Journal of Sports Medicine, and Sports Health. Data was collected from 2000-2020. Each journal’s annual IF score was collected via Scijournal.org. A multivariate regression model was used to predict the influence of different Twitter metrics on IF from 2012-2019. The journal name, number of tweets, and the interaction of the two were used to predict IF. Additionally, Pearson correlaxtion was used to assess correlations between Twitter account metrics and IF. ResultsOver the study period, all IFs increased, except for AJSM. The effect size between number of tweets and IF was not the same for each journal. For every additional tweet, AJSM increased their IF by 0.001, (p= 0.18). Sports Health and OJSM increased their IF by 0.01 (p=0.002) and 0.022, (p=<0.001). KSSTA would expect a decrease in their IF by 0.004 (p=0.55), JSES and Arthroscopy would increase their IF by 0.002 (p=0.71) and 0.001 (p=0.99), but this was not significant. There was a statistically significant positive correlation between annual tweets and IF across all journals. ConclusionMarkers of Twitter account activity, specifically the number of annual tweets, was predictive of an increase in IF among the orthopedic sports medicine journals included in this study.

The Top 100 Most Impactful Articles on the Achilles Tendon According to Altmetric Attention Score and Number of Citations.

Achilles tendon injuries often generate substantial discussion in the mainstream media. The Altmetric Attention Score (AAS) measures the online dialogue pertaining to Achilles tendon research that occurs outside scientific journals, which traditional citation-based metrics fail to capture. To characterize the top 100 most-cited Achilles tendon articles and compare them with the 100 Achilles tendon articles with the highest AAS. A secondary goal was to gain an improved understanding of the online dissemination and interpretation of Achilles tendon research through this comparison. Cross-sectional study. The Web of Science Clarivate database was queried to isolate the 100 most-cited Achilles tendon articles, and the Altmetric database was queried to identify the Achilles tendon articles with the top 100 AAS values. Data elements were extracted for each article including study type, study topic, and geographic origin. The Web of Science Clarivate database search yielded 10,890 articles published between 1970 and 2021. The 100 most-cited articles were published in 35 journals, with the American Journal of Sports Medicine being the most prevalent. The mean (±SD) number of citations was 214.5 ± 86.47. The most prevalent study type was laboratory (28.0%). The most prevalent study topic was treatment (41.0%). Of these articles, 72.0% were European. The Altmetric database search yielded 3810 articles published between 1957 and 2021. The AAS of the top 100 articles ranged from 37 to 476 with a mean of 98.17 ± 85.53. The selected articles were published in 39 journals, with the British Journal of Sports Medicine being the most prevalent. The most prevalent study type was randomized controlled trial (25.0%). The most common study topic was treatment (40.0%). Of these articles, 46.0% were European. Our findings suggest that, although the scientific community remains committed to high-impact journals with articles backed by high citation numbers, there is an increasing opportunity to consume Achilles tendon literature through social media.

Patellar tendon complaints and shear wave velocity patterns in maturing alpine skiers

Introduction&#x0D; Patellar tendinopathy is frequent in adolescent athletes and particularly accentuated in competitive alpine skiers (Fröhlich et al., 2020). Tendinopathies are characterized by long disease histories, and whether they can be healed completely is an open question (Kettunen et al., 2002). Three-dimensional (3D) shear wave elastography (SWE) has proven valuable in the early detection of tendinopathies (Götschi et al., 2023). The aims of this study were to (1) describe the longitudinal progression of patellar tendon complaint prevalence in competitive alpine skiers during adolescence, (2) compare the SWV patterns of skiers that were symptomatic four years ago with those with no history of patellar tendon complaints and (3) analyse whether shear wave velocity (SWV) average values correlate with SWV coefficient of variation (CV).&#x0D; Methods&#x0D; Forty-seven subjects were analysed in this 4-year follow-up study regarding their patellar tendon complaints and SWV patterns. Symptomatic and asymptomatic skiers were identified by clinical examinations including the criteria of pain sensation under loading and palpation-induced pain. SWV was determined by ultrasound-based 3D SWE. Prevalence differences were assessed using Pearson’s χ2 tests. Group differences in the SWV patterns were analysed using unpaired sample t tests. Correlations between SWV average and CV values were analysed by means of Pearson’s correlation coefficient.&#x0D; Results&#x0D; With proceeding adolescence, the prevalence of patellar tendon complaints significantly decreased from 29.8% at baseline assessment (13-16 years) to 12.7% at follow-up assessment (Pearson’s χ2 = 9.429; p = 0.002). Those skiers who were symptomatic at baseline but asymptomatic at the follow-up still had lower average SWV values and higher CVs than asymptomatic skiers with no history of patellar tendon complaints (p = 0.054 and p = 0.011, respectively). Furthermore, there was a significant negative correlation between the tendon SWV average values and their CVs (R = -0.55; p &lt; 0.001).&#x0D; Discussion/Conclusion&#x0D; Despite the decreasing prevalence of patellar tendon complaints in youth competitive alpine skiers after their growth spurt, structural abnormalities appear to remain in asymptomatic subjects with a previous history of patellar tendinopathy, indicating potential long-term implications for mechanical tendon proprieties. The SWV average and CV values were negatively correlated, which underlines our hypothesis that a low SWV is associated with a high CV. This altogether may reflect the degenerative processes in patellar tendons affected by complaints in the early stages of a sports career.&#x0D; References&#x0D; Fröhlich, S., Peterhans, L., Stern, C., Frey, W. O., Sutter, R., &amp; Spörri, J. (2020). Remarkably high prevalence of overuse-related knee complaints and MRI abnormalities in youth competitive alpine skiers: A descriptive investigation in 108 athletes aged 13-15 years. BMJ Open Sport &amp; Exercice Medicine, 6(1), Aticle e000738. https://doi.org/10.1136/bmjsem-2020-000738&#x0D; Götschi, T., Franchi, M. V., Schulz, N., Fröhlich, S., Frey, W. O., Snedeker, J. G., &amp; Spörri, J. (2023). Altered regional 3D shear wave velocity patterns in youth competitive alpine skiers suffering from patellar tendon complaints – A prospective case–control study. European Journal of Sport Science, 23(6), 1068-1076. https://doi.org/10.1080/17461391.2022.2088404&#x0D; Kettunen, J. A., Kvist, M., Alanen, E., &amp; Kujala, U. M. (2002). Long-term prognosis for jumper’s knee in male athletes. A prospective follow-up study. The American Journal of Sports Medicine, 30(5), 689-692. https://doi.org/10.1177/03635465020300051001

Female Authorship Is Driving Studies of Female Athletes: A Systematic Review.

Patient sex is known to affect patient outcomes in sports medicine. Historically, many studies on athletes have focused on male athletes and been generalized to female athletes. Studies with female first or senior authors will isolate female athletes as study participants more frequently than studies with male first or senior authors. Systematic review; Level of evidence, 4. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocols, original research studies published between 2017 and 2021 that analyzed athletes were systematically screened from the 6 top sports medicine journals (British Journal of Sports Medicine; Arthroscopy: The Journal of Arthroscopic and Related Surgery; Knee Surgery, Sports Traumatology, Arthroscopy; American Journal of Sports Medicine; Orthopaedic Journal of Sports Medicine; Sports Health: A Multidisciplinary Approach). Articles were included for analysis if they met the following criteria: (1) original sports medicine research study, (2) analysis involving athletes, and (3) inclusion of ≥10 participants. Exclusion criteria included (1) review articles of any type and (2) cadaveric studies. The determination of author sex was completed using the name-to-gender assignment algorithm Genderize.io (https://genderize.io/). A total of 1146 studies were included in quantitative analysis. There were 246 studies with a female first author (21.5%) and 191 studies with a female senior author (16.7%). When looking at all authors (first, senior, and intermediate), 19.9% were female. Female first authors were over 4 times more likely to isolate female athletes in clinical research than male first authors (17.5% vs 3.8%, respectively; P < .001). Female senior authors were approximately twice as likely to isolate female athletes compared with male senior authors (11.5% vs 5.8%, respectively; P < .001). Female first authors were significantly more likely to perform research isolating female athletes. While improving the frequency of female athlete research is multifactorial, increasing the number of female researchers may have a direct effect on improving gender equality in sports medicine research.

Most cited articles involving lacrosse since 1990 primarily focus on concussion and traumatic brain injury

ABSTRACT Objectives The purpose of this study was to identify the 50 most-cited publications relating to lacrosse since 1990 and conduct a bibliometric analysis of the identified studies Methods Clarivate Analytics Web of Science database was queried to identify all publication titles, abstracts, and keywords for the term ‘lacrosse’ on 9 June 2023. The resulting articles were sorted by total number of citations. Titles and abstracts were included based on their relevance to lacrosse. Once the 50 most cited articles were identified, each article was further analyzed to obtain author name, publication year, country of origin, journal name, article type, research topic, competition level, total number of citations, and the level of evidence. Citation density (total number of citations/years since publication) was calculated and recorded for each of the most-cited studies. Results The 50 most-cited articles were cited 4237 of times with an average of 84 citations per article. The most cited article was cited 637 (15.0%) times. The articles came from 2 different countries, with the United States and Australia comprising 49 and 1 articles, respectively. All articles were published in English. The American Journal of Sports Medicine published the most articles (n = 21, 42.0%). The most studied topic was concussion/traumatic brain injury (n = 18) followed by studies assessing all injuries (n = 7). Collegiate-level lacrosse was the most studied level of competition (n = 22), while high school-level followed (n = 12). Conclusions The majority of the 50 most-cited articles related to lacrosse since 1990 focus on the prevalence, diagnosis and identification of concussion/traumatic brain injury in high school and collegiate-level athletes. These articles are predominantly epidemiological or cohort studies with Level III or IV evidence that almost unanimously originate from the United States.

The utility of platelet-rich plasma in modern orthopedic practices: a review of the literature

Introduction Citation analysis is a useful tool to understand the contributions publications make within their fields. As the use of platelet-rich plasma (PRP) by orthopedic shoulder and elbow surgeons increases, it is vital to highlight influential literature that may inform readers of innovations, new applications, and current trends within PRP research. The purpose of this study was to identify and analyze the 50 most-cited publications related to the use of PRP in shoulder and elbow orthopedics. Methods The Clarivate Analytics Web of Science Database was searched using various Boolean searches. Author name, journal, study type, publication year, number of citations, level of evidence, and geographical origin were recorded for each publication. Results Included publications accumulated 6318 total citations with the most-cited article achieving 561 citations. Most studies were randomized controlled trials of Level I evidence. Authors from the United States (10) produced the most publications, and nearly half (22) of the articles were published in the American Journal of Sports Medicine. Discussion Randomized controlled trials composed much of this analysis. As PRP use within upper extremity orthopedics is refined, studies demonstrating evidence in favor of PRP may replace the publications reviewed in this analysis.

Reconstruction of a Chronic, Retracted Proximal Hamstring Rupture Using Achilles Tendon Allograft

Background: Chronic, retracted proximal hamstring ruptures are a challenging problem and can be a significant cause of pain and disability if left untreated. Allograft augmentation is a viable surgical option with good clinical outcomes. Indications: Indications are symptomatic patients with chronic hamstring ruptures unable to be primarily repaired. Patients typically present with pain, instability, or lack of push of strength. Technique Description: An L-shaped extensile incision is made at the level of the gluteal crease. The gluteus maximus is retracted proximally. The sciatic nerve is identified, neurolysed, and tagged. Following the release of adhesions of the native tendon and confirmation of the inability to complete a primary repair, the Achilles tendon allograft is prepared. The allograft is incorporated with the native tendon and the subsequent hamstring construct is fixed and reduced to the ischial tuberosity with suture anchors. After copious irrigation, the incision is closed with Monocryl and Dermabond (Johnson and Johnson) and a sterile dressing is applied. The patient is placed in a hip brace locked in extension. Results: In a study by Rust et al, examining 72 patients with proximal hamstring ruptures, patients who underwent allograft reconstruction reported activities of daily living and postoperative sports activity equal to those of chronic repair, and inferior to those of acute repair. However, there were no significant differences between groups for patient-reported outcomes among acute and chronic repairs and allograft reconstruction. Moreover, a systematic review, by Van Der Made et al, published in the American Journal of Sports Medicine, included 13 studies that found that Achilles allograft repair for delayed proximal hamstring repair results in outcomes comparable to acute primary repair. Discussion/Conclusion: Although the literature on chronic proximal hamstring repair is fairly limited, studies have shown that proximal hamstring repair with allograft augmentation can be favorable in symptomatic patients. Allograft augmentation for chronic, retracted proximal hamstring ruptures provides increased functional outcomes in comparison with nonoperative management. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Injury Prevention in Female Athletes: Defining the Boundaries of Scientific Literature

Purpose: This study aims to perform a bibliometric analysis centered on recent advancements in injury prevention for female athletes. Methods: The study employed Excel, VOSviewer, and the bibliometric R-package tools to analyze and evaluate relevant records obtained from the Web of Science (WOS) database, using a reliable search methodology. Results: From the WOS database, a collection of 10 560 scientific records was acquired using specific keywords, covering the period between 2010 and 2023. These records were subjected to content analysis, revealing the prevalent themes in this research area. Noteworthy topics included risk, risk factors, prevention, women, exercise, physical activity, epidemiology, injuries, performance, injury, strength, and health. The investigation also indicated that the journals “American journal of sports medicine” and “journal of athletic training” demonstrated the highest level of activity in this field. Regarding research productivity, developed countries, such as the United States and Canada stood out as the most prolific contributors. Moreover, the study recognized Gregory D Myer as the most active author in this area. Conclusion: The convergence of injury prevention in female athletes continues to be a subject of significant research attention. This study highlights that the bulk of the literature on this subject originates from researchers in developed countries. However, it is crucial to recognize that a substantial segment of the global population, particularly in developing nations, lacks sufficient representation in research related to early life psychology concerning exercise and physical activity.

A bibliometric and visualized analysis of meniscus suture based on the WOS core collection from 2010 to 2022: A review.

Meniscus suture is an important treatment method for meniscus injury and contributes to the preservation of proprioception, restoration of knee biomechanics and alleviation of progressive osteoarthritis. However, there are few visualized analyses concerning the present studies of meniscus suture. This paper aims to evaluate the global trends, highlights and frontiers of meniscus suture. A bibliometric analysis was conducted based on the results of studies related to meniscus suture from web of science core collection. VOSviewer, GraphPad Prism, Microsoft Excel and R-bibliometrix were utilized for the bibliometric analysis of country and institution distribution, chronological distribution, source journals analysis, prolific authors and institutions analysis, keywords analysis, and reference co-citation analysis. A total of 950 publications on meniscus suture from 177 different sources were retrieved over the set time span. These publications were completed by 3177 authors from 1112 institutions in 54 countries. The United States was the most prolific country with 7960 citations and 348 publications (36.63%). Furumatsu Takayuki acted as the most prolific author (51 publications), while Robert F LaPrade with 1398 citations was the most-cited author. And more papers were published in the core journals, including American Journal of Sports Medicine, Arthroscopy-The Journal of Arthroscopic and Related Surgery, Knee Surgery Sports Traumatology Arthroscopy and Arthroscopy Techniques. Furthermore, "meniscus healing," "meniscus root tear" seem to be the emerging research hotspots. Notably, the publication trend concerning the all-inside suture technique has been rising during the past decade. The number of research publications on meniscus suture has been continuously risen since 2010. The authors, publications and institutions from the United States and East Asia were still the mainstays in this field. And the all-inside suture may become the mainstream surgical technique in the future, with meniscus healing and meniscus root tears being research highlights recently.

Impact of Reporting Bias, Conflict of Interest, and Funding Sources on Quality of Orthopaedic Research

BackgroundInfluence of factors like reporting outcomes, conflicts of interest, and funding sources on study outcomes, particularly positive outcomes in orthopedics, remains underexplored. As transparency of partnerships in orthopaedic surgery through conflicts of interest statements has increased over the years, there has been a lack of focus on the value of these partnerships in influencing study outcomes. We aimed to investigate the associations between reporting outcomes, conflicts of interest, and sources of funding on study outcomes. MethodsWe reviewed articles published in 1 year in The Journal of Bone and Joint Surgery, The American Journal of Sports Medicine, and The Journal of Arthroplasty. The abstracts were examined for appropriate inclusion, while the authors’ names, academic degrees, funding disclosures, and departmental and institutional affiliations were redacted. There were a total of 1,351 publications reviewed from January 1, 2021 to December 31, 2021. ResultsA significant association was found between positive outcomes and reported conflicts of interest (75% versus 25%, P < .001). Likewise, conflicts of interest showed significant association with industry-sponsored studies (88% versus 12%, P < .001) and evidence level > II (72% versus 28%, P < .001). Industry-sponsored research accounted for the highest percentage of studies involving a conflict of interest (88%) and level I studies (12%). ConclusionsConflicts of interest are significantly associated with positive outcomes in orthopaedics. Sponsored studies were more inclined to have conflicts of interest and accounted for the majority of level I studies.

Publication Rates of Abstracts Presented at American Orthopaedic Society for Sports Medicine Annual Meetings From 2016 to 2019.

Research in the form of poster and podium abstracts is disseminated at subspecialty society meetings. The quality of this research can be defined by exploring the ultimate publication rate of the presented abstracts. To investigate (1) the manuscript publication rate of abstracts presented at the American Orthopaedic Society for Sports Medicine (AOSSM) annual meeting; (2) whether abstract format (poster vs podium) influences overall or 2-year publication rates and time to publication; (3) the abstract factors that are associated with increased publication rate; and (4) whether publication quality as measured by journal of publication, level of evidence (LOE), and number of citations differs between posters and podiums. Cross-sectional study. Poster and podium abstracts that were presented at the AOSSM annual meetings between January 1, 2016, and December 31, 2019, were included. The PubMed and GoogleScholar databases were searched by abstract title and authors to determine whether the related manuscript had been published. For published manuscripts, the journal, journal impact factor (IF), time to publication, authors, and LOE were recorded. The manuscripts of 664 abstracts (341 poster, 323 podium presentations) were published during the study period. The overall publication rate was 52.4%. Publication within 2 years of the meeting was found to be higher in podium abstracts (45.8%) compared with poster abstracts (37.8%) (P = .0366). Podium abstracts had a shorter time to publication (P < .001), higher LOE (P = .0166), more citations (P < .0001), and were published in higher IF journals (P = .0028). Poster presentations were more likely to undergo a change in first author between the time of the conference and future publication (P = .0300). The most common journal of publication was the American Journal of Sports Medicine (36.8%). Abstracts presented at the AOSSM annual meeting had a high rate of publication within 2 years. There was no difference in publication rates between podium and poster abstracts, but podium abstracts had a shorter time to publication and more future citations and were published in journals with higher IFs.

Orthopaedic Sports Medicine Randomized Controlled Trials Infrequently Report on the Social Determinants of Health Factors of Their Patient Cohorts

To describe the prevalence of randomized controlled trials (RCTs) in orthopaedic sports medicine-related journals reporting on the social determinants of health (SDOH) of their patient cohorts, including factors receiving less attention, such as education level, employment status, insurance status, and socioeconomic status. The PubMed/MEDLINE database was used to search for RCTs between 2020 and 2022 from 3 high-impact orthopaedic sports medicine-related journals: American Journal of Sports Medicine, Arthroscopy, and Journal of Shoulder and Elbow Surgery. The following information was extracted from each article: age, sex/gender, body mass index, year published, corresponding author country, and self-reported SDOH factors (race, ethnicity, education level, employment status, insurance status, and socioeconomic status). A total of 189 articles were analyzed. Articles originated from 34 different countries, with the United States (n= 66) producing the greatest number of articles. Overall, age (n= 186; 98.4%) and sex/gender (n=184; 97.4%) were the factors most commonly reported, followed by body mass index (n= 112; 59.3%), race (n= 17; 9.0%), ethnicity (n= 10; 5.3%), employment status (n= 9; 4.8%), insurance status (n= 7; 3.7%), and education level (n= 5; 2.6%). Socioeconomic status was not reported in any of the articles analyzed. Articles from the United States report on SDOH factors more frequently than international articles, most notably race (24.2% vs 0.8%, respectively) and ethnicity (15.2% and 0%, respectively). RCTs from 3 high-impact orthopaedic sports medicine journals infrequently report on SDOH. Better understanding patient SDOH factors in RCTs is important to help orthopaedic surgeons and other practitioners best apply study results to their patients, as well as help researchers and our field ensure that research is being done transparently with relevance to as many patients as possible.

Patient Reported Outcome Measures in the Foot and Ankle Literature: A Systematic Review

Category: Other Introduction/Purpose: Optimising clinical practice requires emphasis on patient-orientated care and therefore patient reported outcome measures (PROMs) play a key role in shaping evidence-based clinical guidelines. As such, it is crucial that we use appropriate, valid and reliable PROMs to quantify outcomes in orthopaedic research. A previous systematic review evaluating evidence published between 2002-2011 identified 139 different PROMs used in the foot and ankle literature and found the most common PROM was The American Orthopaedic Foot and Ankle Society (AOFAS) score. However, in 2011, AOFAS issued a position statement outlining the lack of reliability and validity of the AOFAS score, describing it as a ‘less than ideal’ measure. This systematic review aims to provide an updated analysis of the PROMS used in the foot and ankle literature. Methods: This systematic review was performed according to PRIMSA guidelines. An electronic title/abstract screen of every article published between January 2012- December 2022 in Foot and ankle international, Clinical Orthopaedics and Related Research, Knee Surgery Sports Traumatology and Arthroscopy, The Bone and Joint Journal and The American Journal of Sports Medicine was performed by two reviewers. Articles with a foot and ankle focus were selected for full text screening and papers reporting at least one PROM were included in the final review. The following data was extracted from each article: journal of publication, month/year of publication, pathology/intervention described, PROMS reported and use of the minimally clinically important difference (MCID) to evaluate post intervention changes in PROMs. The number of studies using each individual PROM was calculated and a subgroup analysis was performed to investigate variation in PROM selection according to year of publication, journal of publication and the condition being investigated. Results: A total of 3,174 foot and ankle articles were identified, of which 1,168 (36.8%) articles reporting at least one PROM were included. The most common PROM was the AOFAS score, reported in 50.3% of studies, followed by visual analogue scale (VAS) pain score (44.4%) and 36-item short form survey (SF-36) (15.3%). Use of the AOFAS score declined across the review period. Between 2012-2016 AOFAS was the most common PROM, whilst VAS pain was most common in four of the last six years. Although some variation in PROMs according to clinical pathology exists, AOFAS score is featured in the top 3 most common PROMs for every analysed condition. Only 8/1,168 (0.7%) articles reported the number of patients achieving a minimally clinically important difference (MCID) post-intervention. Conclusion: Whilst use of the AOFAS score declined over the review period, it remains the most common PROM overall across all included journals and many conditions. There exists a lack of consensus regarding the most suitable alternative PROMs, with multiple validated instruments including FAOS, FAAM and FFI used inconsistently with relatively low frequency. There is a heavy reliance on statistical significance to evaluate and compare post-intervention PROM changes. However, it is important to quantify PROMs according to the patient perspective. Reporting the proportion of patients achieving MCID will allow clinicians to interpret PROMs and develop management guidelines in a patient-focused manner.

Diversity Within the Field of Orthopedic Sports Medicine: A Systematic Review.

Orthopedic surgery is among the least diverse specialties in medicine. This systematic review analyzes gender, racial, and ethnic diversity within orthopedic sports medicine and aims to raise awareness and provide guidance for future strategies that support underrepresented minorities in medicine (URMs) and women in joining the orthopedic sports medicine workforce. We hypothesize that at all tiers of training, there is a lack of gender, racial, and ethnic parity in academic rank, leadership positions, and research productivity. A search of all published literature in the English language from PubMed, Embase, Cochrane, and Scopus databases, between January 1, 2010, and August 18, 2023, was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included studies presented demographics regarding diversity within orthopedic sports medicine and provided trends in applicants, attendings, leadership, and/or research. Bias was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) study checklist. Thirteen studies published between 2016 and 2023 with STROBE scores 15.5 to 21.5 (70.5% to 97.7%) met criteria, and pertinent data were extracted. The percent of female orthopedic sports medicine surgeons from 2010 to 2019 increased from 5% (n = 138) to 6% (n = 206) with a compound annual growth rate of 0.2% (r2 = 0.97; p < 0.001). Females and URMs are underrepresented at the highest levels of orthopedic sports medicine leadership including department chair (female: 0% [n = 0]), division chief (female: 4% [n = 4]; URM: 3% [n = 3]), and fellowship director (female: 3.3% [n = 3]; URM: 4.4% [n = 4]). Studies from prominent orthopedic sports medicine journals (American Journal of Sports Medicine, Arthroscopy, Journal of Shoulder and Elbow Surgery, and Sports Health) show a 12.1% increase in female involvement in orthopedic sports medicine research from 1972 to 2018; however, this increase captures 59.3% (n = 2,953) females with degrees other than an MD. Although increasingly more females and underrepresented minorities are joining orthopedic sports medicine, the rate of diversification remains slow and current involvement in leadership and research is minimal. Targeted efforts aimed at increasing research opportunities and inspiring interest through mentorship for URMs and females in orthopedics is essential to drive change toward parity. Level IV. Systematic Review. See Instructions for Authors for a complete description of levels of evidence.

Achilles Tendon Rupture – The Essentials: A Bibliometric Study

Category: Sports; Hindfoot Introduction/Purpose: Achilles tendon rupture and management are among the most prevalent topics in the Foot and Ankle Literature. As the scientific literature increases across all fields of medicine, so too does the literature regarding Achilles tendon rupture. A bibliometric analysis of the current literature will help guide Foot and Ankle surgeons and others interested in learning about or partaking in the treatment of Achilles tendon ruptures. The purpose of this study was to identify and analyze the most- cited and influential research articles regarding Achilles tendon rupture. Methods: Using the Web of Science Database, with the search terms Achilles Tendon Rupture OR Achilles Tendon Tear OR Achilles Tendon Surgery OR Achilles Tendon Repair OR Achilles Tendon Reconstruction, over 1500 publications were identified. The search was then refined to include only original articles, which resulted in 1341 articles (Figure 1). Co-Authorship between authors was analyzed and using a readily available online citation manager software. The 50 most-cited articles were exported from Web of Science into Microsoft Excel for further analysis of publication year, journal, authors, and institution of publication. Results: The 1341 articles were published between 1948 and 2023, a plurality of which were published in 2021 and 2022 (117 and 113 articles, respectively). The top 50 most-cited articles were published between 1974 and 2017, and were cited an average of 170 times, ranging from 79 to 672 citations. RG Young et al.’s article Use of Mesenchymal Stem Cells in a Collagen Matrix for Achilles Tendon Repair was the most-cited article overall and in the past 10 years with 672 and 64 citations overall and since 2013, respectively. The American Journal of Sports Medicine was the most prolific publication, having published 10 of the top 50 most-cited articles. Leppilahti, J., Nilsson-Helander, K., and Silbernagel, K. were the most prolific primary authors, with 2 publications each. Conclusion: There is an immense amount of Achilles tendon rupture research available on the Web of Science. This can make it difficult for Foot and Ankle surgeons and other practitioners interested in the topic to navigate the relevant literature. Bibliometric analyses such as this one can help provide a road map of the most-significant literature available. This study identified and sought to describe the characteristics of the 50 most-influential articles regarding Achilles Tendon Rupture.

Bibliometric and visualized analysis of arthroscopic treatment of acromioclavicular joint injury

BackgroundSince arthroscopy was discovered to treat acromioclavicular joint injury, people have had great interest and attention to this beautiful and minimally invasive operation, and related research has been increasing worldwide. At present, there is no bibliometric and visualized analysis in this field. The purpose of this study is to explore the research hotspots and trends of arthroscopic treatment of acromioclavicular joint injury through bibliometric and visualized analysis and look forward to the future development direction of clinical practice.MethodsThe publications on arthroscopic treatment of acromioclavicular joint injury diseases from its establishment to April 2023 were obtained from the Web of Science (WOS) Core Collection database. CiteSpace, VOSviewer, Scimago graphica and Origin were used for bibliometric and visualized analysis.ResultsThis study included a total of 330 publications. The number of publications tends to increase every year. The USA has the most significant number of publications and citations. Imhoff AB is the most relevant scholar with the largest number of publications in this field, and the scholar with the highest citation and average citations is Mazzocca AD. Tech Univ Munich, Rush University and Charite are the three institutions with the greatest contribution. Tech Univ Munich, Rush University and Charite are the three institutions with the greatest contribution. In addition, “Arthroscopy-the Journal of Arthroscopic and Related Surgery” and “American Journal of Sports Medicine” are the institutions with the most significant number of publications and average citations, respectively. The most common keywords are “acromioclavicular joint dislocation,” “arthroscopic resection,” “arthroscopic reconstruction” and “coracoclavicular ligament.”ConclusionThe number of publications shows a steady upward trend as a whole. However, there is still a lack of cooperation among countries, institutions and scholars around the world, so various countries, institutions and scholars need to strengthen academic exchanges and expand the field of cooperation, so as to promote further research and development in related fields. However, minimally invasive methods such as arthroscopy are still the hotspots and frontiers in the treatment of acromioclavicular joint injury in the future.

Clinically Significant Outcome Scores in Orthopaedic Sports Medicine Shoulder and Knee Surgery Are Increasing in Prevalence but Often Reported Incorrectly

To study the prevalence and quality of application of minimal clinically important difference (MCID), substantial clinical benefit (SCB), patient-acceptable symptomatic state (PASS), and maximum outcome improvement (MOI), reported in the orthopaedic sports medicine knee and shoulder literature in recent years and to bring awareness of proper use of such metrics. A literature review of all shoulder and knee articles published from the American Journal of Sports Medicine (AJSM), Journal of Shoulder and Elbow Surgery (JSES), and Arthroscopy from 2016 to 2020 was performed, specifically investigating whether MCID, SCB, PASS, or MOI were used or reported. Additionally, the way these metrics were reported and interpreted was recorded. Out of 5,039 studies, 889 shoulder and knee studies met the inclusion criteria. Overall, 16.7% reported either MCID, PASS, or SCB. MCID was the most reported across all 3 journals. MCID was reported 12.4% of the time throughout the 5 years. PASS was reported 3.2% and SCB 1.1% of the time over the 5 years. MOI was not reported by any of the journals during this period. There was a statistically significant increase in MCID reporting in 2 of the 3 journals over the 5-year course, Arthroscopy (P= .02) and AJSM (P= .05). There was no statistically significant increase in PASS or SCB reporting rates in all 3 journals. Only 39.1% of studies reported MCID correctly (i.e., defined as the number of individual patients meeting MCID/total patients in the study). This study shows an increasing trend in the use of clinically significant outcome metrics, such as MCID, for interpretation of patient-reported outcomes; however, these individual metrics are often not being used on the individual level and subsequently not reported accurately. We recommend determining whether the specific metric met the threshold per individual patient and then reporting those as a percentage of the sample population to achieve the full potential of these metrics and translate them accurately across various studies. As the usage of clinically significant outcome metrics rises, so does the need for accurate reporting. These findings will encourage future studies to follow a more standardized format.

Trends of Publications on Single- and Double-Bundle ACL Reconstructions over the Last 20 Years: A Bibliometric Analysis of the PubMed Literature

PurposeTo improve the clinical outcomes of anterior cruciate ligament reconstruction (ACLR), there have been attempts to reproduce anatomic reconstruction by modifying the single-bundle (SB) and double-bundle (DB) techniques. Although DB ACLR restores better rotational control compared to SB ACLR, it is still debatable whether there are higher clinical outcomes in favor of DB ACLR. We aimed to study the trends of publications on SB and DB ACLR techniques over the last 20 years.MethodsFor this bibliometric study, we performed a PubMed search on 31/05/2022 with a well-defined search strategy. The articles were downloaded into Excel software, and citations were determined from the iCite website for PubMed. The analysis was performed using SPSS software version 28.0.1. Data mining was performed using Orange software, Mac version 3.32.0, from the titles of all articles and each group of SB and DB ACLR. The output is presented as word clouds.ResultsA total of 10,530 publications were identified, of which 9699 publications (92.1%) pertained to SB-ACLR and 831 publications (7.9%) to DB-ACLR. There was a steady increase in the publications on SB-ACLR until 2012, followed by a steep increase that peaked in 2021. The highest number of publications on DB-ACLR was in 2012 (n = 76; 9.1%). The mean citations per year for SB-ACLR and DB-ACLR were 2.87 ± 4.31 and 2.74 ± 3.17, respectively. The most prolific journals publishing on this topic were Knee Surgery Sports Traumatology Arthroscopy, American Journal of Sports Medicine, and Arthroscopy. The top three articles that received the maximum number of citations were from Japanese authors.ConclusionThe number of publications related to SB-ACLR was significantly higher than that related to DB-ACLR in the last 20 years. The publications related to DB-ACLR have decreased in the recent past, after reaching a peak in 2012. The citations per year of SB-ACLR and DB-ACLR were similar.