Case reports are the oldest and perhaps most basic form of medical publication, typically describing a clinical condition or experience that is either unique or extremely rare. Frequently, a case report provides the only available diagnostic description or therapeutic experience concerning a rare event. Despite their value, case reports became increasingly marginalized in the latter portion of the 20th century as greater emphasis was placed on evidence-based medicine and as the cost of printed page space grew. However, considering the substantial costs and effort required to produce high-level evidence, it became increasingly apparent to JBJS in the early 2010s that online publishing provides an opportunity to make available meaningful scientific information through a large, structured repository of clinical experiences when higher level evidence does not exist.
From that initial vision arose JBJS Case Connector, which marks its 10th anniversary this year. The goal of the Case Connector journal is to establish a sizable and growing inventory of high-quality, peer-reviewed case reports enriched by a collection of keywords and search functionality that will allow healthcare providers to recognize commonalities between cases, benefit from the experience of their peers, identify trends, and distinguish between truly rare cases and repeated single instances of a larger problem. Over the past decade, Case Connector has had considerable success in building toward its goal. In 2011, just over 200 manuscripts from 28 countries were submitted. Of these, 30% were accepted, and 13 articles were published in that first year. In 2020, we received over 1,000 case report submissions from 54 countries; 320 were published, while our quality, perhaps best reflected by a steady acceptance rate of 31%, was maintained. To date in 2021 alone, we have received nearly 500 submissions.
In 1987, then JBJS Editor-in-Chief Henry Cowell suggested guidelines for case reports of the type occasionally published in JBJS1. Although those recommendations were appropriate at the time, more recently, the use of web-based communication and more flexible search tools, allowing greater accessibility to aggregated content, has allowed Case Connector to broaden the scope of publishable case reports2. Illustrative examples of the types of orthopedic problems published in Case Connector include unexpected experience with a new drug or device3,4, exceptional presentation of a disorder that itself may not be rare5,6, unexpected revelation related to new technology7,8, early experience with a new procedure9, unexpected complications10,11, rare neoplasm or genetic disorder12,13, and exceptionally long follow-up of an unusual event14. The increasing use and evolution of the search capabilities on jbjs.org have brought continued efficiency to discovering cases of use to clinicians.
The Case Connector editors have been able to steward the journal's rapid growth thanks to the exceptional expertise and commitment of our highly accomplished Board of Associate Editors, an impressive roster of reviewers including both well-established and emerging leaders in our field, dedicated staff at the JBJS office, and importantly, our authors. Perhaps the best recognition of Case Connector's successful impact on the medical literature is its accessibility through major scientific search engines and databases. Case Connector is indexed in MEDLINE/PubMed, Scopus, CrossRef, and Portico as well as accessible through Ovid.
JBJS Case Connector's successful first decade is steadily propelling us toward our aim to coalescence informative musculoskeletal clinical experiences from physician colleagues worldwide into a large high-quality reference resource. We encourage all sectors of the orthopedic and broader medical community to consider being contributors and users of the online journal. To date, Case Connector reports have been authored by academic scientists, private practitioners, residents, physical therapists, medical students, and other healthcare professionals. Future achievements will require not only the continued support of JBJS, our Board of Associate Editors, and dedicated reviewers but also the sustained enthusiasm and participation of our readership to provide an optimum resource for those seeking to further understand and treat rare and unusual conditions and improve the care of patients.
1. Cowell HR. Editorial. The case report. J Bone Joint Surg Am. 1987;69-A:639.
2. Swiontkowski MF, Tolo VT. The case report redefined with JBJS Case Connect. J Bone Joint Surg. 2013;95:97.
3. Lovecchio F, McCarthy M, Vaishnav AS, York P, Qureshi SA. Early catastrophic failure of a cervical disc arthroplasty: a case report. JBJS Case Connect. 2021;11:e2000185.
4. Plaster S, Holy F, Antony AK. Anaphylactic reaction to tranexamic acid during posterior spinal fusion: a case report. JBJS Case Connect. 2020;10:e2000130.
5. Gaumetou E, Mihluedo-Agbolan KA, Souchet AS, Maupain O. Low-back pain revealing an abdominal aortic aneurysm in a 15-year-old girl: a case report. JBJS Case Connect. 2021;11:e2000240.
6. Lopes-Coutinho L, Rosa J, Santos Silva M, Silva C, Pereira A. Carpal tunnel syndrome as the initial manifestation of wrist bone tuberculosis: a case report. JBJS Case Connect. 2020;10:e2000193.
7. Drynan D, Leroux TS, Zywiel MG. Acute postoperative pulmonary embolism detected at home by a patient's personal activity monitor: a case report. JBJS Case Connect. 2021;11:e2000841.
8. Ikwuezunma I, Fayad LM, Sponseller PD. Case of the missing vertebra—a report of radiographic stitching error in a scoliosis patient. JBJS Case Connect. 2021;11:e21000295.
9. Kow RY, Yuen JC, Ahmad Alwi AA, Abas MF, Low CL. Surgical reconstruction of an open medial malleolus fracture using a novel technique: a case report. JBJS Case Connect. 2019;9:e0163.
10. Maniar AR, Bhatnagar N, Mishra A, Vinchurkar K, Jain D. Rare fungal infection in arthritic knee after stem cell injection managed by novel staged primary arthroplasty: a case report. JBJS Case Connect. 2021;11:e2000354.
11. Taliaferro J. Cash-based stem-cell clinics. The modern day snake oil salesman? A report of two cases of patients harmed by intra-articular stem cell injections. JBJS Case Connect. 2019;9:e0363.
12. Bellinger E, John I, Zaccarini D, Damron TA. Osseous myopericytoma simulating a giant cell tumor of bone: a case report. JBJS Case Connect. 2017;7:e25.
13. Plancher KD, Chan JJ, Bishai SK, Silane M, Ibrahim TF, Petterson SC. DVT and pulmonary embolism following knee arthroscopy: the role of genetic predisposition and autoimmune antibodies: a report of 3 cases. JBJS Case Connect. 2020;10:e0514.
14. Wallis C, Ninomiya JT. Intrapelvic loss of a trial femoral head during total hip arthroplasty: a case report. JBJS Case Connect. 2020;10:e1900118.