You have a great research question or an idea for an innovation that will change your field. You have worked tirelessly to develop the project and are excited with the outcome. Now it is time to disseminate your findings to the world. This talk will give some insight into how to maximise the impact of your writing to reach the largest possible audience. It will discuss what makes a great paper, and provide pointers for navigating the editorial process, from your initial interactions with the editor to handling the sometimes-difficult process of peer review.

Review the complications reporting in 4 prominent spinal journals over the last decade.

Computerised search of the Medline database and hand search was undertaken to evaluate the complication reporting in 4 spinal journals (Spine, European Spine Journal, Journal of Neurosurgery Spine and Journal of Bone and joint surgery) from 2000 to 2009. The articles were divided based on the level of NICE evidence classification A to D.

A total of 88 articles reported spinal complications. Of these 5.9% was level B, 8.8% was level C and 85.3% was level D. There were no RCT's reported relating to complications (Level A) and majority of complications were case reports or expert opinions (level D). For the proportion of level D the rank order of the journals was; Spine (4.8%), European spine journal (3.8%), Journal of neurosurgery spine (5.1%) and Journal of bone and joint surgery was (1.8%). There was no increase in the rate of reporting over the decade. A detailed discussion of the reporting will be presented.

Papers focusing primarily on complications and its management are still not the focus in most surgical journals. This review over the last 10 years confirms that only rare and uncommon complications are reported in the form of case reports. Meta analysis or case series of complication is rarely reported. More focus must be emphasised on reporting mortality and morbidity for education.

Purpose

In recent years, it has become increasingly common to publish the level of evidence of orthopaedic research in journal publications. Our primary research question is: is there an improvement in the levels of evidence of articles published in paediatric orthopaedic journals over time? In addition, what is the current status of levels of evidence in paediatric orthopaedic journals?

Background: One of the disadvantages of the Impact Factor (IF) is self-citation. The SCImago Journal Rank (SJR) indicator excludes self-citations and incorporates quality of citations that a journal receives by other journals, rather than absolute numbers. This study re-evaluated self-citation influence on the 2007 IF for 17 major orthopaedic journals and the difference in ranking using IF or SJR was investigated.

Methods: Divided in a general (n = 8) and specialized (n = 9) group, all journals were analysed for self-citation rate, self-cited rate and citation density. Rankings of the 17 journals for IF and SJR were determined and the difference in ranking was calculated.

Results: Specialized journals had higher self-citation rates (p = 0.05), self-cited rates (p = 0.003) and lower citation-densities (p = 0.01). Both groups correlated for self-citation rate and impact factor (general: r = 0.85 ; p = 0.008) (specialized: r = 0.71 ; p = 0.049).

When ranked for SJR instead of IF, five journals maintained rank, six improved their rank and six experienced a decline in rank. Biggest differences were seen for BMC MD (+7 places) and CORR (− 4 places). Group-analyses for the IF (general: 7.50 – 95%CI 3.19 to 11.81) (specialized: 10.33 – 95%CI 6.61 to 14.06) (p = 0.26), SJR (general: 6.63 – 95%CI 2.66 to 10.60) (specialized: 11.11 – 95%CI 7.62 to 14.60) (p = 0.07) and the difference between both rankings (general: 0.88 – 95%CI –1.75 to 3.50) (specialized: − 0.78 – 95%CI –2.20 to 0.65) (p = 0.20), showed an enhanced underestimation of sub-specialist journals.

Conclusion: Citation analysis shows that general journals tend to use more citations per published article and a larger portion of self-citations constitutes citations of sub-specialist journals compared to more general journals. The SJR excludes the influence of self-citation and awarded prestige by the SJR implies a different quality-evaluation for most orthopaedic journals. A disadvantage using this indicator, is an enhanced effect of underestimation of sub-specialist journals.

The peer review process for the evaluation of manuscripts for publication needs to be better understood by the orthopaedic community. Improving the degree of transparency surrounding the review process and educating orthopaedic surgeons on how to improve their manuscripts for submission will help improve both the review procedure and resultant feedback, with an increase in the quality of the subsequent publications. This article seeks to clarify the peer review process and suggest simple ways in which the quality of submissions can be improved to maximise publication success.

Cite this article: Bone Joint Res 2013;2:245–7.

Background. Patient-rated measures are the gold standard for assessing spine surgery outcomes, but there is no consensus on the appropriate timing of follow-up. Journals often demand a minimum 2-year follow-up, but the indiscriminate application of this principle may not be warranted. We examined the course of change in patient outcomes up to 5 years postoperatively. Methods. The data from 3′334 consecutive patients (1′789 women, 1′545 men; aged 61±15 years) undergoing first-time surgery between 1.1.2005 and 31.12.2010 for differing lumbar degenerative disorders were evaluated. The Core Outcome Measures Index (COMI) was completed by 3′124 (94%) patients preoperatively, 3′164 (95%) at 3 months follow-up, 3′153 (95%) at 1 year, 3′112 (93%) at 2 years, and 2′897 (87%) at 5 years. 2′502 (75%) completed COMI at all five timepoints. Results. The COMI change-score from pre-op to 3 months follow-up correlated significantly with that from pre-op to 12 months (r=0.65;p<0.0001), 24 months (r=0.57;p<0.0001), and 5 years (r=0.51;p<0.0001). COMI decreased significantly from pre-op to 3 months (3.7-points), and from 3 months to 12 months (0.4-points), then levelled off up to 5 years (0.04–0.05 point-change). The course of change up to 12 months differed slightly depending on pathology/whether fusion was done. Conclusion. Stable COMI scores were seen from 1-year postoperatively onwards. As the early post-operative results appear to herald the long-term outcome, a ‘wait and see policy’ in patients with a poor initial outcome is not advocated. The insistence on a 2-year follow-up could result in a failure to intervene early to achieve better long-term outcomes. No conflicts of interest. No funding obtained

It's easy to say that hip resurfacing is a failed technology. Journals and lay press are replete with negative reports concerning metal-on-metal bearing failures, destructive pseudotumors, withdrawals and recalls. Reviews of national joint registries show revision risks with hip resurfacing exceeding those of traditional total hip replacement, and metal bearings fare worst among all bearing couples. Yet, that misses the point. Modern hip resurfacing was never meant to replace total hip replacement (THR). It was intended to preserve bone in young patients who would be expected to need multiple revisions due to their youth and high-demand activities. The stated goal of the developers of the Birmingham Hip Resurfacing (BHR) was to delay THR by 10 years. In the two decades that followed the release of BHR, this goal has been met and exceeded. Much has been learned about indications, patient selection, and surgical technique. We now know that this highly specialised, challenging procedure is best indicated in the young, active male with osteoarthritis, as a complementary, not competitive procedure, to THR. Resurfacing has many advantages. First and foremost, it saves bone, on the day of surgery, and over the next several years by preventing stress shielding. Dislocations are very rare. Leg length discrepancy and changes in offset are avoided. Post-operative activity, including heavy manual labor and contact sports, is unrestricted. More normal loading of the femur and joint stability has allowed professional athletes to regain their careers. Femoral side revisions, if necessary, are simple total hips, and dual mobility constructs allow one to keep the socket. Adverse reactions to metal debris (ARMD), including pseudotumors, have generated great concern. Initially described only in women, it was unclear whether the etiology was allergy, toxicity, or inflammation. A better understanding of the wear properties of the bearing, and its relation to size, anteversion, hip dysplasia and metallurgy, along with retrieval analysis, allow us to conclude that it is excessive wear due to edge loading which is the fundamental mechanism for the vast majority of ARMD. Thus, patient selection, implant selection and surgical technique, the orthopaedic triad, are paramount. What has been most impressive are the truly exceptional results in young, active men. The worst candidates for THR turn out to be the best candidates for resurfacing. The ability to return to full, unrestricted activity is just as important to these patients as the spectacular survivorship in centers specializing in resurfacing. If they are unlucky and face a revision, they are not facing the life-changing outcomes of a long revision femoral stem. So if the best indication for hip resurfacing is the young, active male, let's look at the results of resurfacing these patients in centers with high volumes, using devices with a good track record, such as BHR. Several centers around the world report 10–18 year success rates of BHR in males under 50 at 98–100%. Return to athletics is routinely achieved, and even professional athletes have regained their careers. Hip resurfacing doesn't have to be better than THR to be popular among patients. Just the idea of saving all that bone makes it attractive. In the young active male, however, the results exceed those of THR, while leaving better revision options for the future. This justifies its continued use in this challenging patient population

The contents of 3 orthopaedic journals [JBJS (Am), JBJS (Br) and CORR] during 2001 and 2011 were compared for publication bias. There were total of 2028 articles. After exclusion 1662 scientific articles were analysed for statistical results, clinical conclusion, sub-speciality topics studied, the geographical region the study been conducted and the statistical method used. The articles classified into 7 categories: THR, TKR, Basic sciences, Trauma, Spinal disorders, Paediatric disorders and Tumour. 91% of articles on THR and 95% of articles on TKR were positive studies in 2001. Articles dealing with trauma had the lowest proportion of positive studies (74%) as compared to all other topics. We noted that JBJS (Br) published more negative studies as compared to JBJS (Am) and CORR. In 2011 less articles on THR and TKR had positive studies (68% and 76% respectively). Spinal surgery articles report less number of non significant studies nowadays (24% in 2001 and 2% in 2011). There is a significant change in the trend towards reporting more negative studies in relation with THR and TKR (p < 0.05). Articles dealing with Basic sciences, Trauma, Paediatric disorders and Tumour did not have any significant change in reporting negative studies in the last decade. Significant findings in spinal disorders were 3.8 times more likely to be published than non significant stdies. Overall, JBJS (Br) continued to publish more negative studies as compared to JBJS (Am) and CORR. Journals seem to prefer reporting more significant results with spinal disorders and more non significant results in relation with Hip and Knee arthroplasty in last ten years. This might be because of authors' perceptions of the importance of their findings and journals preferences for significant results

Aims

To report the outcomes of patients with a fracture of the distal tibia who were treated with intramedullary nail versus locking plate in the five years after participating in the Fixation of Distal Tibia fracture (FixDT) trial.

Aims

Lower limb fractures are common in low- and middle-income countries (LMICs) and represent a significant burden to the existing orthopaedic surgical infrastructure. In high income country (HIC) settings, internal fixation is the standard of care due to its superior outcomes. In LMICs, external fixation is often the surgical treatment of choice due to limited supplies, cost considerations, and its perceived lower complication rate. The aim of this systematic review protocol is identifying differences in rates of infection, nonunion, and malunion of extra-articular femoral and tibial shaft fractures in LMICs treated with either internal or external fixation.

Aims

The evidence base within trauma and orthopaedics has traditionally favoured quantitative research methodologies. Qualitative research can provide unique insights which illuminate patient experiences and perceptions of care. Qualitative methods reveal the subjective narratives of patients that are not captured by quantitative data, providing a more comprehensive understanding of patient-centred care. The aim of this study is to quantify the level of qualitative research within the orthopaedic literature.

Objectives

Despite the fact that research fraud and misconduct are under scrutiny in the field of orthopaedic research, little systematic work has been done to uncover and characterise the underlying reasons for academic retractions in this field. The purpose of this study was to determine the rate of retractions and identify the reasons for retracted publications in the orthopaedic literature.

By and large, physicians and surgeons trust what they read, even if they take authors’ conclusions with a pinch of salt. There is a world of difference between being cautious about the implications of what you read and being defrauded by dishonest researchers. Fraud and scientific research are incompatible bedfellows and yet are an unhappy part of our research existence. All subspecialties are to blame and orthopaedics is no exception.

Osteoarthritis is extremely common and many different causes for it have been described. One such cause is abnormal morphology of the affected joint, the hip being a good example of this. For those joints with femoroacetabular impingement (FAI) or developmental dysplasia of the hip (DDH), a link with subsequent osteoarthritis seems clear. However, far from being abnormal, these variants may be explained by evolution, certainly so for FAI, and may actually be normal rather than representing deformity or disease. The animal equivalent of FAI is coxa recta, commonly found in species that run and jump. It is rarely found in animals that climb and swim. In contrast are the animals with coxa rotunda, a perfectly spherical femoral head, and more in keeping with the coxa profunda of mankind. This article describes the evolutionary process of the human hip and its link to FAI and DDH. Do we need to worry after all?