In our study, a significant increase was observed in the number of annual publications focusing on infection in orthopedics worldwide. Each of top 100 cited articles was cited more than 150 times. Total citation times were positively associated with citation times in 2016 and mean citation times per year. Conversely, age of the article was negatively associated with citation times in 2016 and mean citation times per year. Besides, citation times in 2016 was positively related to mean citation times per year. Journal of Bone and Joint Surgery American Volume was the most popular journal, the United States was the most productive country and surgery was the most popular subspecialty.
In this bibliometric analysis, the study entitled “Prevention of infection in treatment of 1000 and 25 open fractures of long bones—retrospective and prospective analyses” was the most popular article, which found that cephalosporin was the prophylactic antibiotic of choice to prevent the infection. The following reasons might account for the popularity of the study. First, this study was conducted in 1976. As is well known, articles published in earlier years were likely to be cited more frequently. Second, the severe wound and following surgery both might increase the risk of infection; therefore, infection caused by open fractures of long bones was a common and intractable problem for orthopedists. Third, the methodology of the study was scientific and strict, which guaranteed the reliability of the conclusion.
It is worth mentioning that our study first explored the relationships among total citation times, age of the article, mean citation times per article and citation times in 2016, which were not performed in previous studies.[12,14,18] We unexpectedly found that total citation times was not obviously associated with age of the article, which challenged the conventional viewpoint that earlier papers were more frequently cited. The main reason might be that investigators paid more attention to the latest developments in this filed. In additions, another explanation for why classic papers were cited less frequently was that they had been absorbed and accepted into the body of current knowledge, therefore no longer being directly attributed to their source. Predictably, total citation times were significantly related to mean citation times per year and citation times in 2016. Our results also indicated age of the article was negatively associated with citation times in 2016, which might be explained with previous theory that peak citation usually occurred after articles were published for 3 to 10 years.
Journal of Bone and Joint Surgery American Volume had the largest number of paper, total citation times, mean citation times per year and citation times in 2016. Therefore, this journal was the most popular journal focusing on infection in orthopaedics. However, it should be noted that Clinical Orthopedics and Related Research had the highest citation times per article among top 6 journals, which demonstrated articles in this journal were of relatively higher quality. Other than that, Spine ranked third, indicating infection was also a problematic issue in spine surgeries. However, when assessing journals’ contribution, we should not ignore that those journals had different publication cycle time and circulation time. Shorter publication cycle time and longer circulation time were beneficial to increasing the citation times of articles. Furthermore, these journals were founded at different time, which also might affect the number of articles and citation times. It should be noted that none of the top 100 cited articles was published in 4 famous medical journals, including British Medical Journal, Journal of American Medical Association, Lancet and The New England Journal of Medicine. This phenomenon indicated that researchers focused on not only the impact factor but also the influence in their research field when choosing journals to publish their studies. Of course, several other factors might influence the selection process of target journal, including difficulty to be accepted, time from submission to acceptance, charges and so on, especially difficulty to be accepted.
The United States ranked first with 75 articles, which was far more than the other countries. This finding was accorded with other previous studies.[21–23] The United States had the highest total citation times, mean citation times per year and citation times in 2016. Besides, most of productive institutions and authors were in the United States. Overall, all this information supported that the United States made the greatest contribution to the developments of research on infection in orthopaedics. Besides, our study found that no developing country such as China was selected in rankings. Previous studies have proved that China made great contribution to the progress of several biomedical fields.[24,25] However, our results uncovered although developing countries such as China published a good deal of papers, the quality of many papers needed further improvement. Therefore, developing countries should try their best to improve the quality of articles in future.
In our study, original articles had higher mean citation times per article when compared with reviews. This finding indicated orthopedists paid more attention to the new findings in this topic. Besides, our bibliometric analysis proved that surgery was the most popular subspecialty. Infection associated with surgery was indeed a very important and common problem in orthopedics, which should raise more researchers’ concern.
To our knowledge, this study was the first bibliometric analysis to identify the top 100 cited papers focusing on infection in orthopedics. And this study helped researchers to catch the scientific developments and promote the cooperation in this field. Nevertheless, our study was not without limitations. First, citation time was not the “Golden Standard” when evaluating the importance of the research. The citation times could be easily affected by several factors, such as time of peer-review process and publication cycle. In recent years, increasing researchers suggested that the impact factor based on citation times should be optimized and even abandoned. Second, this bibliometric analysis was conducted based on WoS database, however, Google Scholar and Scopus were also frequently used to perform the bibliometric analysis, therefore, the results of our study might not be comprehensive. Third, despite of aforesaid methods, we could not guarantee that all retrieved articles exactly focused on this topic, which was an inherent weakness of all bibliometric analyses. Fourth, generally, joint replacement surgeries, degenerative spine surgeries, and infected non-unions were focused in clinical practice when discussing the infection in orthopedics, however, few publications concerned these topics among the top 100 cited articles. This phenomenon might be explained that many factors could affect the citation times of artciels and then determine the top 100 cited articles. In spite of limitations, we believed this study could contribute to obtaining vital developments of infection in orthopedics and providing new insights into innovation in this field.
Infection in orthopaedics has attracted increasing researchers’ concern. As for the top 100 cited articles, there were significant relationships among total citation times, citation times in 2016 and mean citation times per year as well as age of the article. The United States was the most productive country, surgery was the most popular subspecialty and Journal of Bone and Joint Surgery American Volume was the most productive journal.
Guoxing Zhu designed the study; Guoxing Zhu and Yu Jiang conducted the statistical analysis; Yu Jiang and Renjing Hu wrote the manuscript; Guoxing Zhu revised the manuscript; All authors read and approved the final manuscript.
Conceptualization: Yu Jiang.
Data curation: Yu Jiang, Renjing Hu, Guoxing Zhu.
Formal analysis: Yu Jiang, Guoxing Zhu.
Funding acquisition: Guoxing Zhu.
Investigation: Yu Jiang, Renjing Hu, Guoxing Zhu.
Methodology: Yu Jiang, Renjing Hu, Guoxing Zhu.
Resources: Guoxing Zhu.
Software: Guoxing Zhu.
Validation: Guoxing Zhu.
Writing – original draft: Yu Jiang, Renjing Hu, Guoxing Zhu.
Writing – review & editing: Yu Jiang, Renjing Hu, Guoxing Zhu.
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Keywords:Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.
bibliometric analysis; infection; orthopedics