We evaluated the top 13 journals in trauma and orthopaedics by impact factor and looked at the longer-term effect regarding citations of their papers. All 4951 papers published in these journals during 2007 and 2008 were reviewed and categorised by their type, subspecialty and super-specialty. All citations indexed through Google Scholar were reviewed to establish the rate of citation per paper at two, four and five years post-publication. The top five journals published a total of 1986 papers. Only three (0.15%) were on operative orthopaedic surgery and none were on trauma. Most (n = 1084, 54.5%) were about experimental basic science. Surgical papers had a lower rate of citation (2.18) at two years than basic science or clinical medical papers (4.68). However, by four years the rates were similar (26.57 for surgery, 30.35 for basic science/medical), which suggests that there is a considerable time lag before clinical surgical research has an impact. We conclude that high impact journals do not address clinical research in surgery and when they do, there is a delay before such papers are cited. We suggest that a rate of citation at five years post-publication might be a more appropriate indicator of importance for papers in our specialty. Cite this article: Bone Joint J 2014;96-B:414–19

Background. Author credibility and creativity is often gauged by the number of scientific papers published, with the frequency of citations for particular articles reflecting the impact of published data on the area of practice. Aims. The objective of this study was to identify and analyse the qualities of the top one hundred cited articles in Orthopaedic surgery. Methods. We used the database of the Science Citation Index of the Institute for Scientific Information (1945-1995) in addition to Scopus, Medline and Pubmed search engines. Results. 1490 articles were cited in excess of 100 times with the top 100 being subjected for further analysis. The 100 articles discussed were published between 1945 and 2005. The mean number of citations per articles was 446.5 (range 334 - 1786). The majority of published articles originated in the United States (68) with the United Kingdom and Canada closely behind (12 and 5 respectively). The 100 articles were published in 7 Orthopaedic journals led by the Journal of Bone and Joint Surgery American edition (JBJS Am) (n=55) followed by Spine (n=16), Clinical Orthopaedic Related Research (n=14), JBJS Britain (n=7), Journal of Orthopaedic Research (n=5), Acta Orthopaedica Scandinavia (n=2) and Foot and Ankle International (n=1). 80 of the most cited articles reported clinical experiences, 7 were clinical review articles and 13 dealt with basic science. 34 persons authored greater than one top citing article. Conclusion. Analysis of the most cited Orthopaedic papers allows us a unique insight into the qualities, characteristics and clinical innovations, required for a paper to attain the ‘classic’ status. Based on these findings to be well cited such a contribution should be published in the English Language in a high impact journal and originate in North America or the United Kingdom