Assessing the evolution of scientific publications in orthopedics journals from mainland China, Hong Kong, and Taiwan: a 12-year survey of the literature

Rise of Asian research in orthopaedic and sports medicine: a bibliometric analysis from 1996 to 2022

OBJECTIVES

This study examines the growth and impact of orthopaedic and sports medicine (OSM) publications across 30 Asian countries from 1996 to 2022 using a bibliometric (scientometric) approach. Despite Asia's rising academic achievements, prior studies have not comprehensively mapped publication trends in this field across the region. This analysis aims to perform bibliometric analysis in OSM research in the Asian Countries.

METHODS

Publication data were sourced from the SCImago Journal & Country Rank portal, derived from the SCOPUS database, covering the period from 1996 to 2022, with updates available until April 2023. The analysis focused on the top Asian countries and included key indicators such as H-index and total citations to assess research impact.

RESULTS

The study identified a substantial rise in OSM publications from Asia, with total output increasing 14.27-fold-compared to a 5.54-fold increase globally. Between 1996 and 2022, 111,342 OSM publications originated from Asian countries, out of 666,847 globally. However, citation counts for Asian research declined from 26,263 in 1996 to 6020 in 2022, likely reflecting the time-lag effect in citation accumulation for recent publications. Possible contributing factors are discussed.

CONCLUSION

This study highlights a remarkable surge in orthopaedic and sports medicine publications from Asia, surpassing global growth trends. While citation metrics appear lower in recent years-likely due to the recency of publications-the overall trend suggests a strong and growing research in Asia. China and Japan lead in output and impact, respectively, while India's rapid rise reflects increasing academic potential. However, enhancing research quality and visibility and reducing self-citation are essential to elevate global impact. Countries like Hong Kong, Singapore, and Sri Lanka demonstrate high citation efficiency. With optimal collaboration and strategic investment, Asian countries are well positioned to play a leading role in global orthopaedic research.

Orthopedic research productivity of KSA: First bibliometric analysis

Purpose

Medical research is a crucial indicator of a nation's reputation and development. However, there are concerns about the limited orthopedic research in Kingdom of Saudi Arabia (KSA). Therefore, this study conducted bibliometric analysis to investigate orthopedic research output from KSA.

Methods

PubMed database for orthopedic articles, with a minimum of one KSA-affiliated orthopedic author published from the year 2000 onwards, was searched. This excluded duplicate articles, corrections, letters, editorials, commentaries, and brief communications. The titles of the included articles, publication years, first and corresponding authors' primary affiliations and countries, countries and institutes of research, and total citations were noted. Thereafter, year-wise research contribution, top contributing and collaborating nations, top contributing affiliations, study types, levels of evidence, journal distribution, their impact factor, h-index and quartile-related information, and citation trends were analyzed.

Results

The search strategy yielded 1047 eligible articles. An increasing trend in research contributions in recent years was observed, with the least number of articles (8) contributed in 2005 and the most (140) in 2023. The research was conducted in KSA for most articles (83.48%). Authors from Canada collaborated in 3.44% of the articles. King Saud University was the top contributing institution (17.38% of all articles). There were 66 (6.30%) basic science studies and 873 (83.3%) clinical studies. Among non-basic science studies, 84.51% had level IV evidence. Overall, 73.83% of articles had either first/corresponding or both authorships from KSA-affiliated orthopedic authors. The eligible articles were published in 303 journals, with a mean impact factor of 3.04 (range 0.4-51.1, 165 journals) and a mean h-index of 59.2 (range 1-367, 277 journals). Overall, 31.23% of articles with quartile information available were published in first-quartile journals.

Conclusions

The orthopedic research productivity in KSA is limited. However, there has been an increasing trend in orthopedic research in recent years. Nevertheless, the quality of clinical research, particularly the level of evidence, needs improvement. Therefore, further efforts should be made to strengthen research opportunities and encourage research participation among orthopedic and medical institutes.

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

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

Scientific publications on orthopedic surgery from three major East Asian countries (2012-2021)

BACKGROUND

East Asia is the most dynamic region in the world and includes three major countries: Japan, South Korea and China. Due to rapid economic growth, orthopedics research in East Asia has achieved great advances during the past 10 years. However, the current status of orthopedic research in Japan, South Korea and China is still unclear.

AIM

To understand the current status of orthopedic research in Japan, South Korea, and China.

METHODS

Journals listed in the ''Orthopedics'' category of Science Citation Index Expanded subject categories were included. The PubMed and Web of Knowledge electronic databases were searched to identify scientific publications from the selected journals written by researchers from Japan, South Korea and China. A systematic analysis was conducted to analyze orthopedic research articles published in the three countries based on the number of articles, study design, impact factors (IFs) and citations. Furthermore, we also ranked the top 10 countries worldwide with the highest publications in the past 10 years. Additionally, we ranked the top 10 countries with the highest number of publications in the world in the past 10 years. Statistical analyses were performed using SPSS 20.0 software (SPSS Inc., Chicago, IL, United States), and statistical results are given in Tables and Figures. The Kruskal-Wallis test and the Mann-Whitney test were used to detect differences between countries. The tendency regarding the number of articles was analyzed by curvilinear regression. A two-tailed P < 0.05 was considered significant.

RESULTS

From 2012-2021, a total of 144518 articles were published in the 86 selected orthopedic journals. During this period, the number of worldwide published orthopedic articles has shown an annual increasing trend. A total of 27164 orthopedic research articles were published by Japan, South Korea and China during the past 10 years; 44.32% were from China, 32.98% were from Japan, and 22.70% were from South Korea. From 2012 to 2021, the annual number of articles markedly increased in each of the three countries. Over time, the worldwide share of articles increased substantially in South Korea (3.37% to 6.53%, P < 0.001) and China (5.29% to 9.61%, P < 0.001). However, the worldwide share of articles significantly decreased in Japan (5.22% to 3.80%, P < 0.001). The annual total IFs of articles from China were well above those of articles from Japan and South Korea (36597.69 vs 27244.48 vs 20657.83, P < 0.05). There was no significant difference among the articles in the top 10 high-IF orthopedics journals published from those three countries [South Korea (800) > China (787) > Japan (646), P > 0.05].

CONCLUSION

Over the past 10 years, China's scientific publications in orthopedic journals have shown an increasing trend. Considering the relative scale of the populations, Japan and South Korea have outpaced China with respect to quality.

The 100 top-cited articles in the field of Wilson's disease from 1990 to 2022: A bibliometric study

Objectives

To characterize the 100 most-cited articles in the field of Wilson's Disease (WD) to provide a general overview and reveal the historical developments classical studies, and new findings.

Design

WD-related articles were searched on the Web of Science database. The 100 most-cited articles were retrieved and their descriptive statistics were analyzed.

Data extraction and synthesis

The 100 most-cited articles in the field of WD were selected and several parameters, including citation count, citation density, first author, corresponding author, journal, country, institution, and keywords were extracted to assess the overall quality and impact of the articles.

Results

Most of the selected 100 articles were published in the 1990s and 2000s, with the highest number of articles published in 2005. Citations per paper ranged from 100 to 1,631, with a mean number of citations of 199.03. The top 100 articles were published in 38 journals, and the majority were published in the Journal of Biological Chemistry. The most prominent research themes were clinical presentations, clinical trials, copper transport mechanisms, and dysregulation of copper metabolism. Prof. Svetlana Lutsenko, Prof. Peter Ferenci, Prof. George J. Brewer, and Prof. Diane W. Cox were among the most influential researchers in this field, while Euro-American countries were the most dominant in terms of research output. Keywords network analysis identified "Transporting ATPase," "ATP7B," and "Menkes disease" as the most influential keywords. Moreover, disease management, WD clinical phenotype, ATP7B function, and copper metabolism are potential hotspots in future WD research.

Conclusions

This study reveals the most influential articles in the field of WD research. In addition, the major research themes and technological innovations in the field of WD worldwide are presented.

Global Research Trends in the Latarjet Procedure: A Bibliometric and Visualized Study

Background and Objectives: Latarjet is among the procedures indicated to treat shoulder instability, producing excellent results, including low instability rates and high patient satisfaction. The aim of this study was to report the characteristics of scientific articles that address the subject of the Latarjet procedure through the use of bibliometric analysis. Materials and Methods: Bibliographic searches were performed for original articles published in journals indexed by the Web of Science database until 2021, with no language restrictions. Results: A total of 668 articles published in 87 journals were included. The first publication was in 1981; the most registered publications were in 2018 and 2021 (89 articles), with an annual percentage growth rate of 11.9. Provencher MT was the author with the most published articles, and the institutional affiliation with the most original articles was the Steadman Philippon Research Institute. The most cited article was a study by Burkhart and Beer, and the scientific journal with the most publications on the subject was the Journal of Shoulder and Elbow Surgery. Most published studies included keywords such as dislocation, instability, and meta-analysis. Conclusion: There has been a sustained increase in original articles on the Latarjet procedure. However, the greatest growth in articles has occurred during the last decade, demonstrating the considerable interest among the world scientific community.

Global research in arthroscopy of the anterior cruciate ligament: A bibliometric and visualized study

Purpose

To carry out a bibliometric analysis of the scientific articles that address the topic of arthroscopy of the anterior cruciate ligament (ACL).

Methods

A bibliographic search of the original articles published in orthopedics journals indexed in the Web of Science database until 2020 was carried out. Evaluation of compliance with the inclusion criteria was carried out in the Rayyan web application. The Bibliometrix package in the R programming language and VOSviewer were used to perform the bibliometric analysis.

Results

2249 articles published in 87 journals were included. The first publication on the subject was in 1980, and the highest number of publications was registered in 2020 (151) (annual percentage growth rate of 5.7). Fu FH was the author with the highest number of published articles, and the institutional affiliation with the highest number of original articles was the University of Pittsburgh. The most cited article was the study by Peterson et al. (2000) and the journal with the highest number of publications was Arthroscopy: the journal of arthroscopic and related surgery. United States had the highest frequency of publications and the highest number of total citations received by country. It was found on the network that the largest number of published studies had keywords such as: injuries and follow-up, whereas, in the most recent articles, the most common terms were risk-factors and outcomes.

Conclusions

There is a sustained increase in scientific production on ACL arthroscopy among the world scientific community. Our results can be used for collaborative research purposes and by professionals seeking training in this topic.

Institution Origin and Medical School Rank Impact the Citation Frequency and Publication Rate in Orthopaedic Sports Medicine Journals

Purpose

To examine the trends between various categories of institutions with their respective published orthopaedic sports medicine content and to determine the publication output and citation rate from the 25 highest-ranked medical schools compared with lower-ranked institutions.

Methods

Publications between 2015 and 2019 from the American Journal of Sports Medicine, Journal of Bone and Joint Surgery, Journal of Shoulder and Elbow Surgery, Clinical Orthopaedics and Related Research, and Arthroscopy were categorized into university/university affiliated hospitals, non-university affiliated teaching hospitals, public/semi-government research institutes, nonprofit research institutes, private sector institutions, government institutions, and other institutions. Citation rates were collected from PubMed for the first and corresponding author. Similarly, corresponding authors were stratified by U.S. News and World Report 2021 medical school research rankings.

Results

Of the 12,152 publications identified, 5,044 publications met the inclusion criteria. Nonprofit research institutions garnered the greatest number of citations on average (6.44 based on first author, SD 8.83, n = 214; 6.62 based on corresponding author, SD 9.65, n = 208; P < .001), while university/university-affiliated hospitals produced the majority of published articles (77.0% based on first author, 76.8% based on corresponding author), but had lower average citation rates (4.48 based on first author, SD 6.67, n = 3,886; 4.44 based on corresponding author, SD 6.55, n = 3,873; P < .001). Furthermore, of 1953 medical school publications, the top 25 accounted for 53.1% of publications; however, there was no statistical difference between their citation rates and those of lower rankings (P = 0.47).

Conclusions

Publications are cited at different rates, depending on their institution of origin. In addition, high-ranking medical schools produce a disproportionately greater output of publications than lower-ranking schools, but there is no statistically significant difference in citation rates on an individual publication basis.

Clinical Relevance

Knowing how an institution’s ranking influences publication and citation rates can help us understand bias in the scientific literature.

Analysis of Eastern Asia’s Contributions to Major Orthopaedic Journals in the Past 21 Years

Introduction

Over the past two decades, Asia has experienced the rise and integration of Western medicine and digital health in its field of medicine. In this study, we investigated the trends in orthopaedic publications from three Asian countries: China, Japan, and Korea.

Methods

PubMed was used to measure the number of publications from China, Japan, and Korea in the past 21 years, from 1998 to 2020. The average percentage change in publications during this 21-year time period was analyzed using descriptive statistics. The average annual change in the number of publications from each country was also determined. One-way analysis of variance and two-group t-tests were utilized for statistical analyses with a p-value of <0.05 as the cut-off value for statistical significance.

Results

From years 1998 to 2020, there was a mean 35.5% ± 70.7% annual increase in the number of total publications from China, in comparison to a 5.1% ± 14.0% annual increase from Japan (p = 0.005) and a 27.3% ± 40.0% annual increase from Korea (p = 0.586).

Conclusion

For the past two decades, there has been a strong positive trend regarding the total number of orthopaedic publications from China. This finding might be related in part to an increased integration of Western medicine and the use of digital medicine, which followed a similar trend during the time period we analyzed. Korea and Japan also exhibited a positive trend in orthopaedic publications, which may be indicative of an improving educational system and greater general support for research.

Academic Publication of Neurodegenerative Diseases From a Bibliographic Perspective: A Comparative Scientometric Analysis

Background: For measuring the impact in clinical and scientific research, the citation count of the articles is used in the bibliometric analysis, although there is no comprehensive summary of neurodegenerative disease research. This study intends to provide the neuroscientists and investigators with a practical reference guide to appraise the most important and influential articles written on this subject through a macroscopic view of the research activities on neurodegenerative diseases. Materials and Methods: The Clarivate Analytics Web of Science was searched in July 2020. To ensure the breadth of the search scope, the search terms were confirmed as "multiple sclerosis" (MS) or "amyotrophic lateral sclerosis" (ALS) or "Parkinson's" or "Alzheimer's" or "Huntington's" or "neurodegenerative." After excluding completely unrelated articles, the top-cited articles were collected and evaluated from special characteristics. The data analysis was performed using SPSS 18.0. The articles were characterized by citation number, publication year, topic, study type, authorship, journal, country, and institute of responding author and foundation. Results: The query identified 593,050 articles. A total of 45% of the top-cited articles were published during 2000-2009, followed by 30 articles from 1990-1999. Diagnosis and pathology were the main research categories (n = 62). Alzheimer's disease (AD) was the main study topic (n = 43). Meanwhile, the United States confirmed the tremendous impact on the field of neurodegenerative diseases. Notably, 69 of 100 articles were studied in the United States, and the National Institutes of Health sponsored 49 articles. There were only 22 articles that can be divided by evidence level. No article was categorized as level 1 evidence. In the journal list with multiple articles, seven of 15 were general journals. The 58 authors, who contributed to more than one article, have been identified by VOSviewer, and the clusters of authors reveal the evolution of research focus in neurodegenerative diseases. Conclusions: This study analyzed the bibliometric characteristics and connections of 100 top-cited articles in the field of neurodegenerative diseases in the Web of Science. Their main outcomes were as follows: First, the pathology and diagnostic researches took a major role in top-cited articles while the therapy articles are relatively less. Second, the United States confirmed the tremendous impact on the field of neurodegenerative diseases. Third, researchers also submitted their researches to general journals, not just focused on specialty journals.

Bibliometric evaluation of orthopaedics and traumatology publications from France: 20-year trends (1998-2017) and international positioning

BACKGROUND

Little is known about the scientific publication output for individual countries and medical specialties. The contribution of French authors to the currently expanding volume of publications on orthopaedics and traumatology (OT) is unclear. Orthopaedics & Traumatology: Surgery & Research (OTSR) is an English-language version of a preexisting French journal that was launched in 2009 to increase the dissemination of research done in France. The objective of this study was to use Web of Science (WoS) data from 1998 to 2017 to determine (i) the contribution of OT publications to the total worldwide volume of scientific publications, (ii) the contribution of OT publications from France to the total worldwide volume of OT publications, and (iii) changes over time in the proportion of OT publications from France with special attention to potential effects of the creation of OTSR.

HYPOTHESIS

The proportion of OT publications from France increased after 2010-2012, indicating a positive effect of OTSR.

MATERIAL AND METHODS

WoS data were used to identify original studies and review articles written by at least one French author, published between 1998 and 2017, and dealing with OT (defined as orthopaedics and/or traumatology in adult and/or paediatric patients). The worldwide volumes of publications in OT and other specialties were compared. Within worldwide OT publications, the proportion from France was determined. Indicators of impact were evaluated during successive 5-year periods. Finally, the position of OT in worldwide research was assessed and OT journals were analysed.

RESULTS

Among worldwide scientific medical publications, the proportion dealing with OT increased year on year from 1.93% in 1998 to 2.65% in 2017. Among annual publications from France, the proportion dealing with OT rose similarly, from 1.32% to 2.40%. Over the 20-year study period, France moved from the sixth to the ninth position, chiefly due to a large increase in publications from Asia. However, France remained in third position among European countries and increased its OT production 3-fold between 1998 and 2017. The proportion of OT articles from France that ranked among the top 1% most cited articles increased by 65% from 2008-2012 (20 articles) to 2013-2017 (33 articles), and the proportion in the top 10% increased by 31.8% (211 in 2008-2012 and 278 in 2013-2017). This rate of progression was faster than in any of the other western countries. Between 1998-2011 and 2012-2017, the contribution of French OT to publication output showed a 1.56-fold greater increase than did the contribution of OT to the worldwide volume of scientific medical publications.

DISCUSSION

OT publications from France have kept pace with the steady increase seen worldwide over the last 20years. Although the US and UK remain in the lead, and despite the considerable growth in the output of Asian countries, France occupies a prominent position on the international OT scene. The creation of OTSR has elevated the international profile of French OT centres.

LEVEL OF EVIDENCE

IV, retrospective study with no control group.

Assessment of Korea's Orthopedic Research Activities in the Top 15 Orthopedic Journals, 2008-2017

Background

Bibliometrics is increasingly used to assess the quantity and quality of scientific research output in many research fields worldwide. This study aims to update Korea's worldwide research productivity in the field of orthopedics using bibliometric methods and to provide Korean surgeons and researchers with insights into such research.

Methods

Articles published in the top 15 orthopedic journals between 2008 and 2017 were retrieved using the Web of Science. The number of articles, citations and h-index (Hirsch index), funding sources, institutions, and journal patterns were analyzed.

Results

Of the total 39,494 articles, Korea's contribution accounted for 5.6% (2,161 articles), ranking fifth in the world in the number of publications. Korea ranked sixth (with 29,456) for total citations worldwide but ranked 17th (13.64) in terms of average citation per item and 14th (55) in terms of h-index. Korea showed the most prolific productivity in the field of sports medicine and arthroscopy. The institution that produced the highest number of publications was Seoul National University (n = 386, 17.9%).

Conclusions

Orthopedic research in South Korea demonstrated high productivity in terms of the number of publications in high-quality journals between 2008 and 2017. However, total citations and average citations per article were still relatively low. Efforts should be made to increase citation rates for further improvement in research productivity in the field of orthopedics.

Bibliometric analysis of scientific publications in rheumatology journals from China and other top-ranking countries between 2007 and 2017

Objectives

Rheumatology-related diseases remain a significant burden worldwide. However, little is known about the comparative status of rheumatology research between Mainland China (MC) and the world’s leading countries. The aim of this study is to compare the quantity and quality of research output in the field of rheumatology that were written by researchers from MC, the USA, the UK, the Netherlands and France.

Methods

Between 2007 and 2017, all articles published in 30 rheumatology journals were identified via Science Citation Index Expanded database. The number of total and annual articles, article types (randomized controlled trials (RCTs), reviews, case reports, clinical trials and meta-analysis), impact factor (IF), citations, h-index and articles in the high-impact journals were collected for quantity and quality comparisons. The correlation of socioeconomic factors and annual publications was also analyzed.

Results

From 2007 to 2017, there were 53,439 articles published in rheumatology journals, of which researchers from the USA published 13,391 articles, followed by the UK, the Netherlands, France and MC with 6,179, 4,310, 4,066 and 2,898 articles, respectively. Publications from MC represented the ninth, but the number is growing rapidly. For total and average citations, MC still lags behind the other four countries in the study. Similar trends were observed in average IF, h-index and articles in the high-impact journals. In terms of article types, the USA occupies the dominant place, except for meta-analysis. The annual numbers of articles from MC and the USA were positively correlated with gross domestic product (p < 0.05).

Conclusions

The USA has played predominant role in rheumatology research for the last 11 years. The annual number of published articles from MC has increased notably from 2007 to 2017. Although MC has made progress in the number of published articles over the past decade, it still lags far behind the highly developed countries in most bibliometric indicators. Thus, the general quality of publications from MC needs further improvement.

A 14-year literature survey on spine-related clinical research output by orthopedic surgeons from mainland China

BACKGROUND

In recent years, China is increasingly playing an active role in various fields of biomedical research. Many bibliometric studies have provided valuable insights to different fields of clinical studies. However, similar evaluation on spine surgery-related clinical research is still limited. We herein aimed to examine the scientific publications by orthopedic spine surgeons from mainland China within a 14-year period.

METHODS

Articles were identified in PubMed using predetermined query terms. Descriptive statistics were calculated, and T tests, Chi-squared tests, and regression analysis were conducted on the number of publications, impact factors (IFs), citations, region of the study, and associated medical subject headings (MeSHs).

RESULTS

A total of 1498 articles were identified and the annual number of publications, citations, and IFs all increased exponentially. The average IF was significantly higher in 2007 to 2013 than 2000 to 2006. Most publications were from Shanghai and Beijing and the 5 most productive administrative regions generated 70% of all publications. Analysis of associated MeSHs suggested research topics became more heterogeneous over the study period.

CONCLUSION

This was the first comprehensive evaluation on the clinical research output by orthopedic spine surgeons from mainland China. The annual number of publications and citations both increased significantly; however, research was highly concentrated in a handful of administrative regions.

Scientific research output in orthopaedics from China and other top-ranking countries: a 10-year survey of the literature

OBJECTIVES

Orthopaedics-related diseases and conditions are a significant burden worldwide. In this study, we aimed to compare the quantity and quality of research output in the field of orthopaedics from Mainland China (MC), USA, UK, Japan and Germany.

SETTING

The USA, UK, Japan, Germany and MC.

PARTICIPANTS

We selected orthopaedics journals from the subject category 'orthopedics' from the Science Citation Index Expanded (SCIE).

OUTCOME MEASURES

The number of publications, the number of publications in the surveyed publication types, impact factor (IF) and citations from the corresponding country from 2005 to 2014 were collected for quantity and quality comparisons.

RESULTS

A total of 128 895 articles were published worldwide in orthopaedics-related journals from 2005 to 2014. The USA contributed the largest proportion (31 190 (24.20%)), followed by the UK (6703 (5.20%)), Japan (5718 (4.41%)), Germany (4701 (3.66%)) and MC (3389 (2.63%)). Publications from MC represented the fewest, but this quantity is rapidly increasing. The quantity of annual publications from MC has exceeded that of Germany since 2012. The USA plays a predominant role in all kinds of publication types under investigation in the study, except in the category of meta-analysis. MC was in the last place for cumulative IFs, and the average IF actually decreased from the beginning of the study. For total and average citations, MC still lags behind the other countries in the study.

CONCLUSIONS

The USA has occupied the dominant place in orthopaedics-related research for the last 10 years. Although MC has made great progress in the number of published works in the field of orthopaedics over the last 10 years, the quality of these publishing efforts needs further improvement.