A survey of orthopaedic journal editors determining the criteria of manuscript selection for publication

Background: To investigate the characteristics of editors and criteria used by orthopaedic journal editors in assessing submitted manuscripts. Methods: Between 2008 to 2009 all 70 editors of Medline listed orthopaedic journals were approached prospectively with a questionnaire to determine the criteria used in assessing manuscripts for publication. Results: There was a 42% response rate. There was 1 female editor and the rest were male with 57% greater than 60 years of age. 67% of the editors worked in university teaching hospitals and 90% of publications were in English.The review process differed between journals with 59% using a review proforma, 52% reviewing an anonymised manuscript, 76% using a routine statistical review and 59% of journals used 2 reviewers routinely. In 89% of the editors surveyed, the editor was able to overrule the final decision of the reviewers.Important design factors considered for manuscript acceptance were that the study conclusions were justified (80%), that the statistical analysis was appropriate (76%), that the findings could change practice (72%). The level of evidence (70%) and type of study (62%) were deemed less important. When asked what factors were important in the manuscript influencing acceptance, 73% cited an understandable manuscript, 53% cited a well written manuscript and 50% a thorough literature review as very important factors. Conclusions: The editorial and review process in orthopaedic journals uses different approaches. There may be a risk of language bias among editors of orthopaedic journals with under-representation of non-English publications in the orthopaedic literature

Arthroscopic washout of the knee: a procedure in decline.

BACKGROUND: Osteoarthritis (OA) of the knee is a chronic, progressive condition which often requires surgical intervention. The evidence for the benefits of arthroscopic debridement or washout for knee OA is weak and arthroscopy is currently only indicated in the UK if there is a history of mechanical locking of the knee. OBJECTIVES: To investigate whether there has been any change in the number of arthroscopies performed in the UK since the 2007 NICE guidance on knee arthroscopy and the 2008 Cochrane review of arthroscopic debridement for OA of the knee. METHODS: We interrogated data from the Hospital Episodes Statistics (HES) database with Office of Population Censuses and Surveys-4 (OPSC-4) codes pertaining to therapeutic endoscopic operations in the 60-74 year old and 75 and over age groups. RESULTS: The number of arthroscopic knee interventions in the UK decreased overall from 2000 to 2012, with arthroscopic irrigations decreasing the most by 39.6 per 100,000 population (80%). However, the number of arthroscopic meniscal resections increased by 105.3 per 100,000 (230%) population. These trends were mirrored in both the 60-74 and 75 and over age groups. CONCLUSIONS: Knee arthroscopy in the 60-74 and 75 and over age groups appears to be decreasing but there is still a large and increasing number of arthroscopic meniscal resections being performed

Are bisphosphonates effective in the treatment of osteoarthritis pain? A meta-analysis and systematic review.

Osteoarthritis (OA) is the most common form of arthritis worldwide. Pain and reduced function are the main symptoms in this prevalent disease. There are currently no treatments for OA that modify disease progression; therefore analgesic drugs and joint replacement for larger joints are the standard of care. In light of several recent studies reporting the use of bisphosphonates for OA treatment, our work aimed to evaluate published literature to assess the effectiveness of bisphosphonates in OA treatment

The management of the painful bipartite patella: a systematic review

Purpose: This study aimed to identify the most effective method for the treatment of the symptomatic bipartite patella. Methods: A systematic review of the literature was completed, and all studies assessing the management of a bipartite patella were included. Owing to the paucity of randomised controlled trials, a narrative review of 22 studies was completed. A range of treatments were assessed: conservative measures, open and arthroscopic fixation or excision and soft tissue release and excision. Results: All of the methods provided results ranging from good to excellent, with acceptable complication rates. Conclusions: This is a poorly answered treatment question. No firm guidance can be given as to the most appropriate method of treating the symptomatic bipartite patella. This study suggests that there are a number of effective treatments with acceptable complication rates and it may be that treatments that conserve the patella are more appropriate for larger fragments

Mortality and morbidity of stairlift injuries: analysis of the UK TARN Database

Aims: To investigate the incidence and pattern of injury in patients with a diagnosis of a fall from a stairlift. Methods: Data was analysed from the Trauma Audit and Research Network (TARN) database from 2000 to 2018 for those recorded suffering stairlift related injuries between the ages of 40-100 years. Patient demographics, injury mechanism and pattern, mortality rate and height of fall were analysed. Results: 1069 patients were identified in the initial search with 651 having an eligible mechanism of injury. The mean age was 82 (range 41.4-100.1) years. The most common site of injury was the limbs (49.2%) with the most severe injuries to the head (mean AIS 3.1). The mean ISS was 12.5 (Range 1-75). There was no relationship between height of fall and ISS (rs 0.054 p= 0.4). Individuals were 78% more likely to have an ISS score of 15 or more if they had a head injury, (OR: 0.12; 95% CI: 0.06-0.24) and 79% more likely to have sustained an injury to the thorax (OR: 0.21; 95% CI: 0.11-0.41). Injury to the head was 95% more likely in individuals with an ISS score greater than 25 points or more (OR: 0.05; 95% CI: 0.01-0.16) and 69% more likely for those who sustain injury to the thorax. Individuals with an ISS score of 25 points or more were 18 times more likely to have sustained injury getting off their stair lift compared to any other method of falling from their stair lift. Mortality was associated with injuries to the thorax in those aged 70 years or below, injuries to the face, spine and limb for those aged 71 to 85 years and with head injury in those over 85 years. The overall mortality rate was 15.7%. Conclusion: Falls from stairlifts commonly result in limb injuries and most severe injuries are sustained to the head. When patients fall getting off from a stairlift, have injuries to their head or thorax they have a higher ISS. The overall mortality is 15.7%. Given the increasing use of stairlifts in our ageing population, strategies should be considered to make these safer

Do journals raise their impact factor or SCImago Ranking by self-citing in editorials? A bibliometric analysis of trauma and orthopaedic journals

Background: Impact factor (IF) is widely accepted as a measure of a journal's quality but it can be influenced by self-citation. However, the SCImago Journal Rank (SJR) is based on journal prestige, excludes self-citation and considers quality of citations of a journal. This study aimed to investigate journal editors' use of self-citation and whether this correlated with IFs or SJR in trauma and orthopaedic (T&O) journals. Methods: T&O journals on the SJR database were identified. From each journal, data including country of publication, number of annual issues, IF, SJR indicator and citable articles were extracted. The editorial(s) of each issue in 2018 were reviewed. The total number of times the editors cited their own previous work or their journal (in the preceding 2 years, 2016–2017) were identified. Regression analyses were performed to investigate the association of editorial self-citation with journal IF or SJR indicator. Results: Of the 270 journals identified, 43 T&O journals with 151 editorials were included in the final analysis. A positive correlation between journal self-citation in the editorial and IF (P = 0.02) and SJR indicator (P = 0.02) was found. Citation by editors of their own publications within editorials also positively correlated with IF (P = 0.04) but not for SJR indicator (P = 0.19). There was a positive linear relationship between journal IF and SJR indicators (P < 0.01). Conclusion: Editor self-citation influences the IF and SJR indicators in T&O journals. Therefore, these metrics should be considered in conjunction with other factors such as audience, topics included and international presence when evaluating journals

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio