Journal Of Bone Research Articles

Do prospective randomized controlled trials comply with filed protocols? Spin study of 206 trials from 2010 to 2023

IntroductionProspective randomized controlled trials (RCT) have a robust methodology, but some distortions may occur during the course of study. Some protocols may not be available at the time an article is reading. Some authors may change the methodology between the time the protocol was submitted and when the trial results are actually published. Others may distort results to favor more attractive findings and draw conclusions that support prior hypotheses. This has rarely been investigated and none explored the RCTs published in the Journal of Bone and Joint Surgery (JBJS). Therefore, we did a retrospective investigation aiming to determine: (1) the proportion of trials with a protocol deposited and accessible to the reader, (2) whether the trials scrupulously followed the filed protocols. HypothesisProtocols were available in over 80% of cases, and these protocols were followed in over 80% of trials for the primary endpoint. Patients and methodsThis was a retrospective study of articles published in the JBJS between January 2010 and November 2023. Differences in primary and secondary endpoints between protocols and articles were sought. ResultsOf the 206 RCT articles studied, 113 (54.9%) described clear and identifiable endpoints, and 93 (45.1%) were not identifiable and were inferred in the results; 184 (89.3%) articles identified a trial protocol. For the 184 articles (89.3%) declaring a trial protocol in the text, 23 (11.1%) protocols were not accessible. In all, 45 articles (21.8%) thus had no protocol available on the Internet (i.e., not available to the reader either because it was not cited in the text or because it was not accessible) so we analyzed 161 articles. The primary endpoint remained unchanged in 97 articles (60.2%) out of the 161 studied, was changed in 64 articles (39.8%), and was lacking (protocol not accessible) in 45 articles (21.8% of all articles). The secondary endpoints of the articles were unchanged in 61 articles (37.9%) out of the 161 studied. DiscussionLike other leading journals, JBJS publishes RCT articles containing a significant proportion of inconsistencies between preoperative trial protocols and the methods actually used in the research. Level of evidenceIII; retrospective comparative study non randomized

A Review of Authorship Inflation and Multicenter Collaboration Trends in Orthopedic, Medical, and Surgical Journals Over the Last 60 Years.

Over the past six decades, authorship numbers in academic publications have increased significantly, a phenomenon known as authorship inflation. This study aims to analyze comparative authorship trends and the influence of multicenter collaborations across major orthopedic, medical, and surgical journals. We reviewed metadata from The New England Journal of Medicine (NEJM), Annals of Surgery (AS), and The Journal of Bone and Joint Surgery (JBJS) from January 1, 1960, to December 31, 2019. The number of authors per publication, the prevalence of multicenter studies, and their correlation were analyzed. Data was visualized using heat maps and box plots, and trends were statistically tested using the Jonckheere-Terpstra, Mann-Kendall, and generalized linear mixed models (GLMMs). A total of 73,062 articles were analyzed, with 1,190 articles identified as originating from multicenter studies. The number of multicenter trials was found to have increased significantly over time (p < 0.001), plateauing in NEJM but continuing to rise in JBJS and AS. There was a significant increase in authorship numbers per publication over time, across all journals (p < 0.0001). There was a significant statistical correlation (p < 0.0001) as indicated by the coefficient of determination (r2), for the association between the proportion of publications with >10 authors and the proportion of multicenter publicationsacross all three journals. Authorship inflation in academic publishing may be attributable to the rise in multicenter collaborations. The rate of increase in authorship was more pronounced in medical and surgical journals compared to orthopedic journals, reflecting differing trends across specialties. These findings highlight the evolving nature of research collaboration and authorship practices in academic publishing.

The Role of Journals in Reporting Sex and Gender-Based Outcomes: Should We Adopt Guidelines, and What Else Can We Do to Improve Reporting?

➤ Sex and gender are inconsistently reported in musculoskeletal research. A panel of journal editors and other interested parties who participated in The Journal of Bone and Joint Surgery Sex and Gender Reporting in Musculoskeletal Research Symposium met in 2023 to help define the roles of journals and other stakeholders in addressing this issue.➤ This report summarizes the resulting recommendations and presents several different ways in which orthopaedic journals may elect to introduce to their readers, reviewers, and authors the importance of considering sex and gender in orthopaedic research.➤ Many current sex and gender-related funding agency mandates as well as the Sex and Gender Equity in Research (SAGER) guidelines are most readily applied to prospective research and/or randomized controlled trials.➤ The panel was supportive of endorsing SAGER or a similar set of guidelines as a tool that can help authors to consider the most effective means of evaluating the influences of sex and gender within the context of orthopaedic research.➤ Engaging readers, reviewers, and authors on multiple fronts, with purpose and intention, is likely the most important approach to increase awareness and to enhance the quality of evidence utilized to support clinical decisions in orthopaedic surgery.

Trends and predictors of reporting social determinants of health in shoulder surgery

IntroductionThe role of social determinants of health (SDH) in patient outcomes, quality of life, and overall well-being has been well documented. However, the inclusion of these variables in randomized control trials (RCTs) remains limited; thus, the extent of generalizability from such trials is brought into question. The purpose of this study is to explore the rates of reporting SDH variables in RCTs focused on shoulder surgery from the past decade. MethodsThe PubMed database was searched for RCTs with a focus on shoulder surgery from 2013-2023. Duplicates, responses to the editor, biomechanical studies, and non-shoulder studies were excluded. Each article was reviewed and data pertaining to patient demographics, socioeconomic covariates. Journal of publication was recorded, and studies from the five most common journals were analyzed. These journals were the Journal of Shoulder and Elbow Surgery (JSES), the Journal of Bone and Joint Surgery (JBJS), the American Journal of Sports Medicine (AJSM), the Bone and Joint Journal (BJJ), and The Journal of the American Medical Association (JAMA). Multivariate logistic regression was performed to determine the independent effect of study characteristics on the reporting rates of SDH. ResultsA total of 255 articles were reviewed. Of these, 93.3% and 90.2% of articles reviewed reported age and sex, respectively. Employment status was reported in 11.8% of articles. Fewer than 10% reported race, ethnicity, income, insurance, and housing, with even less performing formal analyses on these variables. Studies that were conducted in the United States (US), multicenter, had a sample size 251+, and had a combination of public and private funding were significantly more likely to report on race and ethnicity. Reporting employment status was significantly associated with being European-based, multicenter, sample size 251+, double-blinded, and published in AJSM, Newer studies were significantly less likely to report education. Only publication in AJSM was significant for reporting income. Study intervention and topic were not significant for any SDH reporting. DiscussionThis data reflects how small of a proportion of RCTs report and analyze on SDH variables. These findings reflect a need for future RCTs to accurately report SDH variables that influence outcomes, such as race, ethnicity, education, employment, income, housing status, and insurance.. ConclusionsSDH are infrequently reported and analyzed in RCTs pertaining to shoulder surgery. Academic medical journals should incorporate guidelines to encourage studies to include such variables and enable the assessment of outcomes to apply to a broader population.

Global Highly Cited Publication Trends and Research Hotspots in Osteoporosis and Bone Metabolic Cells: A Bibliometric and Visualization Analysis from 2013 to 2023.

Bone metabolic diseases such as osteoporosis are caused by disruption of the metabolic balance between osteoblasts and osteoclasts. Thousands of papers have been published on osteoporosis and bone metabolizing cells. The purpose of this study is to draw the publication trend of highly cited literature in this field through bibliometrics and to explore the research hotspot analysis. This paper provides a comprehensive analysis of the impact of countries/regions, research institutions, authors, keywords, relevant journals, and references in the field of osteoporosis and bone metabolic cells research, with a specific focus on the theme of "Osteoporosis and bone metabolic cells". Furthermore, utilizing bibliometric methods, the study aims to offer valuable insights and references for future research endeavors, as well as clinical prevention and treatment strategies in this domain. The Web of Science [WOS] Core Collection database was examined in order to identify articles with high citation counts from 2013 to 31 October 2023. The citation counts, authors, year of publication, source, journal, geographical origin, subject, article type, and level of evidence were further analyzed using the R bibliometric package. The VOSviewer software was utilized to visualize word co-occurrence in a total of 251 articles. Our search strategy included 251 highly cited articles published between 2013 and 2023 in the field of osteoporosis and bone metabolic cells. The number of publications in this field remains consistently high, indicating ongoing research interest. Notably, the United States has made significant achievements and contributions in this area. Xie Hui, Cao Xu, and Goodman, Stewart are among the main contributors to these advancements. NATURE MEDICINE has the highest journal impact factor of 82.9, highlighting its prominence. The JOURNAL OF BONE AND MINERAL RESEARCH ranks first with 1,322 citations. Keyword research topics in this field include osteoclast differentiation, osteoblast differentiation, and mesenchymal stem cells. Through citation analysis, we found that 195 articles have been cited more than 100 times, demonstrating their significance and impact. This study analyzed the relationship between osteoporosis and bone metabolic cells using a bibliometric method. The results of these analyses can help researchers gain a more direct and scientific understanding of trends in the field. Additionally, it can provide guidance in identifying hot research directions and offer new ideas for the prevention and treatment of osteoporosis.

Knowledge Mapping of Macrophages in Osteoporosis: A Bibliometric Analysis (1999-2023).

Osteoporosis is a common metabolic disorder that significantly impacts quality of life in the elderly population. Macrophages play a crucial role in the development of osteoporosis by regulating bone metabolism through cytokine secretion. However, there is a lack of scholarly literature in the field of bibliometrics on this topic. This study provides a detailed analysis of the research focus and knowledge structure of macrophage studies in osteoporosis using bibliometrics. The scientific literature on macrophage research in the context of osteoporosis, retrieved from the Web of Science Core Collection (WoSCC) database spanning from January 1999 to December 2023, has been incorporated for bibliometric examination. The data is methodically analyzed and visually represented using analytical and visualization tools including VOSviewer, CiteSpace, Scimago Graphica, the Bibliometrix R package, and Pajek. In the last quarter-century, there has been a consistent rise in the quantity of scholarly publications focusing on the relationship between macrophages and osteoporosis, resulting in a total of 1499 research documents. These studies have originated from 45 different countries, with China, South Korea, and the United States being the most prominent contributors, and the United States having the highest frequency of citations. Noteworthy research institutions involved in this field include Shanghai Jiao Tong University, Wonkwang University, Huazhong University of Science and Technology, and Seoul National University. The Journal of Bone and Mineral Research is widely regarded as the premier and most frequently referenced publication in the field. These publications involve the collaboration of 8744 authors, with Lee Myeung Su contributing the most articles, and Takayanagi being the most co-cited author. Key emerging research focal points are encapsulated in keywords such as "mTOR," "BMSCs," "bone regeneration," and "exosome." The relationships between exosome from macrophage sources and those from BMSCs, along with the regulatory role of the mTOR signaling pathway on macrophages, represent crucial directions for future development in this field. This study represents the inaugural comprehensive bibliometric analysis detailing trends and advancements in macrophage research within the osteoporosis domain. It delineates recent frontiers and hotspots, providing valuable insights for researchers in this particular area of study.

Analysis of the orthopaedic trauma literature utilizing machine learning and latent dirichlet allocation

Objectives: To demonstrate a new method to review literature utilizing machine learning and latent Dirichlet allocation and summarize the past 20 years of orthopaedic trauma research. Methods: All original research articles published in the Journal of Bone and Joint Surgery American volume, Journal of Orthopaedic Trauma, Journal of Bone and Joint Surgery British volume, Trauma, Injury, Clinical Orthopaedics and Related Research, and the Journal of the American Academy of Orthopaedic Surgeons from 2000-2020 were analyzed using latent Dirichlet allocation (LDA), which is a form of machine learning. 100 topics were created by the algorithm and only topics that were relevant to trauma were included, leaving 30 topics ranked by popularity and associated with a best-fitting article and trend over the past 20 years. Results: Research article abstracts totaling 21,968 from 2000-2020 in the orthopaedic trauma literature were analyzed to create 30 topics. The topics were ranked by popularity, trended over the specified time period, and associated with a best fitting article. The 3 “hottest” and “coldest” topics were visualized in graphical form. Conclusions: This is the first study of its kind to utilize machine learning as a method of reviewing the orthopaedic trauma literature. Machine learning possesses the ability to rapidly synthesize a large body of literature to assess the current state of research and trends of research topics. Machine learning can aid clinicians and researchers in time-intensive tasks to quickly provide clues that will promote avenues further research.

Global Trends in Research of Programmed Cell Death in Osteoporosis: A Bibliometric and Visualized Analysis (2000-2023).

Osteoporosis (OP) is a systemic metabolic bone disease that is characterized by decreased bone mineral density and microstructural damage to bone tissue. Recent studies have demonstrated significant advances in the research of programmed cell death (PCD) in OP. However, there is no bibliometric analysis in this research field. This study searched the Web of Science Core Collection (WoSCC) database for literature related to OP and PCD from 2000 to 2023. This study used VOSviewers 1.6.20, the "bibliometrix" R package, and CiteSpace (6.2.R3) for bibliometric and visualization analysis. A total of 2905 articles from 80 countries were included, with China and the United States leading the way. The number of publications related to PCD in OP is increasing year by year. The main research institutions are Shanghai Jiao Tong University, Chinese Medical University, Southern Medical University, Zhejiang University, and Soochow University. Bone is the most popular journal in the field of PCD in OP, and the Journal of Bone and Mineral Research is the most co-cited journal. These publications come from 14,801 authors, with Liu Zong-Ping, Yang Lei, Manolagas Stavros C, Zhang Wei, and Zhao Hong-Yan having published the most papers. Ronald S. Weinstein was co-cited most often. Oxidative stress and autophagy are the current research hot spots for PCD in OP. This bibliometric study provides the first comprehensive summary of trends and developments in PCD research in OP. This information identifies the most recent research frontiers and hot directions, which will provide a definitive reference for scholars studying PCD in OP.

Publication Trends in Osteoporosis Treatment: A 20-Year Bibliometric Analysis.

Osteoporosis prevalence continues to escalate with the growth of the older adult population. In this study, we aimed to investigate the profile of osteoporosis treatment-related research articles published in the past 20 years using bibliometric analysis. We analyzed all osteoporosis treatment-related articles published between 2001 and 2020 in the Web of Science (WoS) database using bibliometric methods. In the Title search section in WoS, we searched the documents using "osteoporosis treatment"-related keywords. We used the VOSviewer software to construct the bibliometric maps of keyword co-occurrences. Our search yielded 29,738 publications, 21,556 (72.5%) were original articles and 4,529 (15.2%) were review articles and review articles (4,529). We noticed a steady increase in the publication numbers from 2001 to 2020. The overall scientific publication number in WoS increased 3.5-fold, with the five most productive countries being the USA, China, Germany, the United Kingdom, and Japan. The largest contributor was the University of California system. The most productive journals were Osteoporosis International (1,679, 6.4%), Bone (832, 3.2%), and the Journal of Bone and Mineral Research (727, 2.8%). We observed increasing trends in the appearance of denosumab and teriparatide during the last two decades. In our keyword co-occurrence analysis, we constructed four keyword clusters using VOSviewer. In this study, we provided a gross overview of the visibility and productivity of research studies in osteoporosis treatment. Substantial changes have occurred in osteoporosis treatment over the last 20 years. The effector mechanism of anti-osteoporosis medications could be future hot spots in osteoporosis research. We believe that our study is a valuable guide for clinicians related to the global outputs of osteoporosis treatment.

Incidence, Diversity, and Quality of Publications in Orthopaedic Trauma Literature

Introduction: Modern medicine increasingly relies on evidence-based care, using academic journals as vehicles for information dissemination. Increasing rates of publication have led to an overwhelming volume of literature. This study evaluates the proportion of dedicated orthopaedic trauma literature, the frequency of different topic domains, and the quality of currently published information. Methods: Top orthopaedic journals were selected by impact factor and scientific articles published between 2016 –2019 were evaluated. All articles were categorized by subspecialty and pre-defined topic domains and level of evidence was recorded. Results: 3,697 articles were published in Journal of Orthopaedic Trauma (JOT), Clinical Orthopaedics and Related Research (CORR), the Journal of Bone and Joint Surgery (JBJS), and Bone and Joint Journal (BJJ). 32% of articles were dedicated to orthopaedic trauma topics. Joint Arthroplasty was the most published subspecialty in general journals (35.37%, P&lt;0.002). Hip fractures were the most prevalent trauma topic domain in all four journals (15.5%, P&lt;0.002). Pelvic ring injuries were the second most prevalent topic in orthopaedic trauma journals, versus distal radius fractures in non-trauma journals (P&lt;0.05). 48.4% of published literature was level III evidence, with no differences between trauma and non-trauma publications (P&gt;0.05). Conclusion: Orthopaedic trauma is well represented within the orthopaedic literature with a diverse distribution of topics over the four-year period, second only to Joint Arthroplasty which was by far the most common topic in general orthopaedic journals. Level of Evidence in trauma literature parallel other orthopaedic subspecialties, but there is an overall low proportion of level I and II studies in the orthopaedic literature. Level of Evidence: Level II

Metabolic and Skeletal Characterization of the KK/Ay Mouse Model-A Polygenic Mutation Model of Obese Type 2 Diabetes.

Type 2 diabetes (T2D) increases fracture incidence and fracture-related mortality rates (KK.Cg-Ay/J. The Jackson Laboratory; Available from: https://www.jax.org/strain/002468 ). While numerous mouse models for T2D exist, few effectively stimulate persistent hyperglycemia in both sexes, and even fewer are suitable for bone studies. Commonly used models like db/db and ob/ob have altered leptin pathways, confounding bone-related findings since leptin regulates bone properties (Fajardo et al. in Journal of Bone and Mineral Research 29(5): 1025-1040, 2014). The Yellow Kuo Kondo (KK/Ay) mouse, a polygenic mutation model of T2D, is able to produce a consistent diabetic state in both sexes and addresses the lack of a suitable model of T2D for bone studies. The diabetic state of KK/Ay stems from a mutation in the agouti gene, responsible for coat color in mice. This mutation induces ectopic gene expression across various tissue types, resulting in diabetic mice with yellow fur coats (Moussa and Claycombe in Obesity Research 7(5): 506-514, 1999). Male and female KK/Ay mice exhibited persistent hyperglycemia, defining them as diabetic with blood glucose (BG) levels consistently exceeding 300mg/dL. Notably, male control mice in this study were also diabetic, presenting a significant limitation. Nevertheless, male and female KK/Ay mice showed significantly elevated BG levels, HbA1c, and serum insulin concentration when compared to the non-diabetic female control mice. Early stages of T2D are characterized by hyperglycemia and hyperinsulinemia resulting from cellular insulin resistance, whereas later stages may feature hypoinsulinemia due to β-cell apoptosis (Banday et al. Avicenna Journal of Medicine 10(04): 174-188, 2020 and Klein et al. Cell Metabolism 34(1): 11-20, 2022). The observed hyperglycemia, hyperinsulinemia, and the absence of differences in β-cell mass suggest that KK/Ay mice in this studyare modeling the earlier stages of T2D. While compromised bone microarchitecture was observed in this study, older KK/Ay mice, representing more advanced stages of T2D, might exhibit more pronounced skeletal manifestations. Compared to the control group, the femora of KK/Ay mice had higher cortical area and cortical thickness, and improved trabecular properties which would typically be indicative of greater bone strength. However, KK/Ay mice displayed lower cortical tissue mineral density in both sexes and increased cortical porosity in females. Fracture instability toughness of the femora was lower in KK/Ay mice overall compared to controls. These findings indicate that decreased mechanical integrity noted in the femora of KK/Ay mice was likely due to overall bone quality being compromised.

Coronavirus disease-2019 and orthopedics: A bibliometric analysis of the literature.

The coronavirus disease-2019 (COVID-19) pandemic has had a dramatic impact on global health, with orthopedics among the most affected specialties. An increasing number of COVID-19-related orthopedic studies have been published. The purpose of this study was to analyze the orthopedic literature published during the COVID-19 pandemic to guide future research. The Scopus database was searched for relevant literature published between 2020 and 2022. The keywords used in the retrieval process were ("COVID-19" OR "Coronavirus" OR "2019-nCoV" OR "SARS-CoV-2" OR "Betacoronavirus" OR "novel coronavirus 2019" OR "novel coronavirus" OR "coronavirus-19" OR "COVID 19" OR "nCOV" OR "COVID-2019" OR "COVID 2019") and ("orthopedic" OR "orthopedics" OR "orthopedic" OR "orthopedical" OR "orthopedical" OR "orthopedics"). Spreadsheet software (Excel, Microsoft Corp., Redmond, WA) was used to analyze the top 10 cited authors, countries, journals, and articles. The top 5 publication types were also analyzed. VOSviewer (Center for Science and Technology Studies, Leiden, Netherlands) was used to network and visualize the literature. A total of 1619 publications relevant to COVID-19 and orthopedics were reviewed. Among these publications, the most active country, author, and publication type included the United States, Vaishya R, and original articles, respectively. The most frequently used keywords were human, coronavirus disease-2019, pandemic, and orthopedics. The Journal of Bone and Joint Surgery American Volume was the most cited journal, whereas the greatest number of articles was published in the Journal of Clinical Orthopedics and Trauma. This study provides a perspective on the development of orthopedic publications during the COVID-19 pandemic and evidence for researchers worldwide to strengthen global cooperation in fighting the epidemic.

Global Publication Trends and Research Hotspots of the Immune System and Osteoporosis: A Bibliometric and Visualization Analysis from 2012 to 2022.

Osteoporosis (OP) is a systemic bone metabolism disorder in which the immune system and bone metabolism interact. The purpose of this study was to explore the research status, hot spots and trends regarding the influence of the immune system on OP and to provide a basis for research directions and applications in this field. We searched and collected literature about the immune system and OP published from 2012 to 2022 in the Web of Science Core Collection database. All the included studies were subjected to bibliometrics analysis using Hiplot Pro, VOSviewer and CiteSpace software to produce statistics and visual analyses of the literature output, countries, institutions, authors, keywords and journals. A total of 1201 papers were included, and the number of citations of these articles reached 31,776. The number of publications and citations on the immune system and OP has increased year by year. The top three countries with the greatest number of papers published were China, the United States of America (USA) and Italy. The two institutions with the largest number of papers published were Sichuan University and Soochow University, both located in China. De Martinis Massimo (Italy) and Ginaldi Lia (Italy) are prolific authors in this field. The representative academic journals are Osteoporosis International, Frontiers in Immunology, Journal of Bone and Mineral Research, PloS One and Bone. The results of the keyword cooccurrence analysis showed that the research topics in this field mainly focused on T cells, cytokines, signaling pathways, vitamin D, postmenopausal OP and immune diseases. The keyword burst results showed that zoledronic acid, chain fatty acids and gut microbiota are the frontiers and trends of future research on this topic. The influence of the immune system on OP has been widely studied, and the current research in this field focuses on the effect or mechanism of immune-related cytokines, signaling pathways and vitamin D on OP. Future research trends in this field should focus on the immune regulation mechanism and clinical transformation of zoledronic acid, chain fatty acids and the gut microbiota in OP.

Global trends in the research on Legg-Calve-Perthes disease in Web of Science.

Legg-Calve-Perthes disease (LCPD) is a form of idiopathic femoral head necrosis that can lead to permanent femoral head deformities and premature osteoarthritis in children under the age of 15. Its pathogenesis is utterly and remains to be clarified. Although many research publications on LCPD have emerged during the last few decades, few systematic bibliometric analyses of these articles have been reported. A bibliometric analysis was performed to investigate the development processes and hotspots, as well as the collaboration and influence among countries, institutions, authors, journals, and keywords of papers relevant to LCPD from the Web of Science Core Collection (WoSCC) during the period from 1 January 2000 to 30 June 2023. A total of 2,205 researchers from 916 institutions across 53 countries/regions have contributed to 673 papers published in 199 academic journals. The research on LCPD has shown significant fluctuations but a gradual increase in the number of articles published over the last two decades. The United States leads in the number of publications of LCPD, with the Texas Scottish Rite Hospital for Children being the most productive institution. English, as the most widely used language in the world, was undoubtedly the most popular language. Herring JA, who acted as both the corresponding and first author, has contributed to the most co-cited papers published. The most number of LCPD papers are published in the Journal of Pediatric Orthopaedics, whereas the Journal of Bone and Joint Surgery American Volume garnered the highest total citations, indicating the great importance of these two journals in the field of orthopedics. The most frequently used keywords in published articles were related to the symptoms, mechanisms, and prognosis, revealing the research focus of most scholars. Our research described the development trends and hotspots in the research field of LCPD and will help researchers make better decisions.

Machine learning review of hand surgery literature

Background: Latent Dirichlet Allocation is an artificial intelligence model which processes text into topics, and has had broad application in medicine, political science, and engineering. As the orthopedic hand literature continues to grow, such technology may have value in efficiently conducting identifying trends and conducting systematic reviews. The purpose of this study is to demonstrate the use of Latent Dirichlet Allocation and machine learning to review literature and summarize the past 21 yr of hand surgery research. Methods: All original research articles published in the Journal of Hand Surgery (American), Journal of Hand Surgery (European), Hand, Journal of Bone and Joint Surgery (JBJS), Clinical Orthopaedics and Related Research (CORR), Journal of the American Academy of Orthopaedic Surgeons (JAAOS) and Plastic and Reconstructive Surgery (PRS) from 2000-2021 were analyzed using Latent Dirichlet Allocation, generating 50 topics which were then ranked by popularity and trended over the previous 21 yr. Results: Research article abstracts totaling 11,501 from 2000-2020 were extracted and analyzed to create 50 topics. Conclusion: This is the first study of its kind to utilize machine learning models for reviewing the hand surgery literature. Machine learning possesses the ability to rapidly process a large body of test and assess the current state of research and trends or research topics, which can aid clinicians and researchers in time-intensive tasks to provide clues that will promote areas of further study.

Top fifty cited articles on humeral fractures

Humeral fractures (HF) are common orthopedic pathologies. Reviewing the content and quality of influential literature over time is important to advance scientific research regarding a specific topic. This study aims to explore and appraise the fifty most cited HF studies that had been published in orthopedic literature. The Web of Science database was used to conduct a systematic search for articles pertaining to HF. Articles were sorted out in descending order of citations and were included based on their relevance to HF. Data and metrics of the included studies were recorded. The methodological quality of the studies was assessed using the Modified Coleman Methodology Score (MCMS) and the Methodological Index for Non-randomized Studies criteria. Statistical analysis was conducted to explore any significant relationships between the date of publication and other relevant variables. Included articles (N= 50) were published between 1959 and 2015, with a total of 14,864 accumulated citations. Europe and North America contributed to all but one of the included studies. The Journal of Bone and Joint Surgery contributed to the highest number of included articles with 27 articles (54%). The proximal humerus was the most commonly explored HF location in our study (72%). The average MCMS and Methodological Index for Non-randomized Studies scores were reported to be 64.6 and 10.4, respectively, and the majority of articles (52%) were considered level four case series. Year of publication was found to have a positive correlation with increasing level of evidence(r=-0.301, P=.044), citation density (r= 0.734, P < .001), and MCMS score (r= 0.41, P= .01). The level of evidence, MCMS scores, and citation density of influential HF literature has been increasing with time, reflecting the increasing effort and work being put in that field. While the findings seem encouraging, additional high-quality research is needed to help achieve better treatment strategies and outcomes.

Increase in Early Onset Scoliosis Publications in Major Orthopaedic and Spine Journals: 2005-2020

Study Design: Retrospective review Purpose: To quantify trends in published research in 8 major orthopaedic and spine journals related to Early Onset Scoliosis (EOS) from 2005-2020. We also investigated publication trends in specific subtopics within EOS research. Methods: The electronic archives of 8 journals (Spine, European Spine Journal, Journal of Children’s Orthopaedics, Spine Deformity, Journal of Pediatric Orthopaedics, Journal of Pediatric Orthopaedics B, The Journal of Bone and Joint Surgery-American Volume and The Bone and Joint Journal) were queried for articles published from 2005-2020 containing search terms particular to the following subtopics of EOS research: congenital scoliosis, infantile scoliosis, thoracic insufficiency syndrome, scoliosis casting, Traditional Growing Rod, Vertical Expandable Prosthetic Titanium Rib, Magnetically Controlled Growing Rod and EOS in general. Results were screened to exclude editorials, conference papers and corrections. Included EOS articles were aggregated and analyzed with respect to journal, year of publication and subtopic. Results: From 2005-2020, a total of 32,000 publications were identified, of which 1,818 (5.7%) were qualified as EOS articles by the presence of at least one search term. The annual number of EOS articles increased from 60 in 2005 to 157 in 2020 and the annual ratio of EOS articles to total publications increased from 4.1% to 7.9%. Congenital spine-related terms matched to the greatest number of articles, while implant-related terms collectively experienced the greatest percentage increase in matching articles per year. Conclusion: The number of EOS articles published in 8 major orthopaedic and spine journals increased in both absolute and relative terms from 2005-2020. Implant-related subtopics saw the greatest increase.

Wiltse Approach for Lumbar Microdiscectomy and Foraminotomy: 2-Dimensional Operative Video.

Far lateral disc herniations account for between 7% and 12% of all disk herniations and occur predominantly at L3/4 and L4/5.1,2 They can cause severe radicular pain due to dorsal root ganglion involvement and are exacerbated by lateral bending to the side of the lesion. Back pain is less of a feature with this pathology.3 The Wiltse approach was first described in the 1960s as an approach to L5/S1 noninstrumented fusion for isthmic spondylolisthesis4; its use in pedicle screws and far lateral discs was described in 1988.5 It has been shown to reduce muscle atrophy, wound infection, and blood loss.6,7 The Wiltse approach for a far lateral disc herniation provides a direct route to the disc pathology and as such is useful in cases with this isolated pathology. It confers less extensive muscle dissection and therefore less postoperative pain, minimal bone resection with preservation of the integrity of the facet joint, and it does not rely on endoscopy (rather the traditional operating microscope). It can also be used where endoscopy is contraindicated such as in revision cases. Here we present the case of a 53-year-old woman who presented with several weeks of back pain and right L3 radiculopathy, as well as right hip flexion and knee extension weakness. A Wiltse approach microdiscectomy was proposed for her far lateral disk herniation, and the patient consented to the procedure. At 6 weeks of follow-up, her radicular pain had resolved and there was improvement in hip flexion and knee extension. Image at 5:50 of Surgical Video is used with permissions from the Wiltse, L, Bateman, JD, Hutchinson, RH, and Nelson, WE. The Paraspinal Sacrospinalis-Splitting Approach to the Lumbar Spine. J Bone Joint Surg Am. 1968;50(5):919-926. Copyright © 1968 by The Journal of Bone and Joint Surgery, Inc.

The Current State of International Academic Partnerships in Orthopaedic Surgery Between High-Income and Low and Middle-Income Countries: A Systematic Review.

Orthopaedic academic partnerships between high-income countries (HICs) and low and middle-income countries (LMICs) are an effective method to increase research and scholarly support. The purpose of this study was to perform a systematic literature review of the current state of partnerships worldwide and assess the quality, quantity, and content of their research output. A systematic review was conducted using 4 academic databases: PubMed, MEDLINE, Embase, and CENTRAL. Article eligibility criteria included articles published between January 2017 and 2022, with orthopaedic authors from at least 1 HIC and LMIC. Articles related to global orthopaedic surgery with exclusively HIC or LMIC authors were excluded. The database search yielded 25,928 articles, and after deduplication, 21,145 articles were included in the screening. After title and abstract screening, 408 articles underwent full-text review for eligibility. The final list of eligible articles for extraction included 310 publications in 127 journals. Published articles increased over time (46 in 2017 to 88 in 2021) and were most commonly published in the Journal of Bone and Joint Surgery (20, 6.5%). Open-access articles (203, 65.5%) had a significantly greater Journal Citation Indicator (p = 0.024) than non-open-access articles. Most studies (40.7%) were observational, with few (3.6%) randomized controlled trials. Orthopaedic trauma (38.1%) was the most common subspecialty, followed by spine (14.8%) and pediatrics (14.2%). Most partnerships were sponsored by North American authors in 65 LMICs, primarily China, India, and the sub-Saharan African region. This study identified 310 articles published by orthopaedic international academic partnerships in 106 countries over the past 5 years, demonstrating that collaborations between LMIC/HIC partners nearly doubled over the study period. Sixty-five percent of the articles were published in open-access journals.

Study Characteristics and Impact of the “Best Papers” Presented at ASSH Annual Meetings Over the Past Decade

Each year, the American Society for Surgery of the Hand (ASSH) selects several abstracts for podium presentations during a "Best Papers" session. We examined these papers to better understand their characteristics and impact on the field of hand surgery. "Best Papers" from the 2010 to 2020 ASSH Annual Meetings were reviewed. Online databases were searched to find matching publications. Descriptive data were collected from the publications. The Hirsch index value for each corresponding author and the number of citations for each publication were recorded. Descriptive statistics were used to analyze the data. Fifty-nine "Best Papers" were awarded during the study period. Forty-nine (83%) were clinical and 10 were basic science studies. A total of 39 observational studies, 11 human trials, 8 experimental studies, and 1 case series were present. Fifty-four (91.5%) were published at the time of our review. Twenty-six of those (48%) were multicenter studies, and the remaining 28 were from a single institution. The average time from presentation to publication was 16 months. The top three journals of publication were the Journal of Hand Surgery (33%), the Journal of Bone and Joint Surgery (9%), and the Journal of Hand Surgery, European (7%). The median level of evidence for all "Best Papers" was 3, with a trend toward a higher level of evidence during the study period. The average h-index value of all corresponding authors was 27.3. The average number of citations per publication was37. The ASSH "Best Papers" were primarily clinical studies with an increasingly strong level of evidence and were likely led by an author with a history of research productivity. Selection as a "Best Paper" at ASSH Annual Meetings is a strong predictor of future publication and impact. This study evaluates the "value" of the best paper designation at the ASSH annual meeting.