Background: The open-access model has changed the landscape of academic publishing over the last 20 years. An unfortunate consequence has been the advent of predatory publishing, which exploits the open-access model for monetary gain by collecting publishing fees from authors under the pretense of being a legitimate publication while providing little-to-no peer review. This study aims to investigate the predatory publishing phenomenon in orthopaedic literature. Methods: We searched Beall’s List of Predatory Journals and Publishers and another list of predatory journals for journal titles that are possibly related to orthopaedics. We then searched their web sites for the following information: total number of articles published, journal country of origin, author country of origin, article processing charge (APC), quoted review time, and location of the listed headquarters. We also reported the article quality of a random sample of these journals. We consulted InCites Journal Citation Reports to determine the number of nonpredatory orthopaedic publications that are indexed, and we manually searched a random sample of these legitimate journals for Beall’s criteria. Additionally, we searched the Directory of Open Access Journals (DOAJ) and PubMed databases for any possible predatory journal titles. Results: We found 104 suspected predatory publishers, representing 225 possible predatory journals. One journal was indexed in the DOAJ, and 20 were indexed in PubMed. Review time was not identified for 56.2% of the journals, and 36.5% quoted a review time of <1 month. Nearly half of the listed addresses of the publishers were either unsearchable or led to residential or empty lots. Eighty-two legitimate journals were identified. The median APC was $420 for predatory journals and $2,900 for legitimate journals. We found that a random sample of the legitimate journals published studies with higher reporting standards, but a few also contained 1 criterion that is found on Beall’s list. Conclusions: This study highlights the scope of orthopaedic predatory publishing. Possibly predatory journals outnumber legitimate orthopaedic journals. Orthopaedic surgeons should be aware of the suspected predatory journals and consult available online tools to identify them because distinguishing them from legitimate journals can be a challenge.

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Aims Malignancy and surgery are risk factors for venous thromboembolism (VTE). We undertook a systematic review of the literature concerning the prophylactic management of VTE in orthopaedic oncology patients. Methods MEDLINE (PubMed), EMBASE (Ovid), Cochrane, and CINAHL databases were searched focusing on VTE, deep vein thrombosis (DVT), pulmonary embolism (PE), bleeding, or wound complication rates. Results In all, 17 studies published from 1998 to 2018 met the inclusion criteria for the systematic review. The mean incidence of all VTE events in orthopaedic oncology patients was 10.7% (1.1% to 27.7%). The rate of PE was 2.4% (0.1% to 10.6%) while the rate of lethal PE was 0.6% (0.0% to 4.3%). The overall rate of DVT was 8.8% (1.1% to 22.3%) and the rate of symptomatic DVT was 2.9% (0.0% to 6.2%). From the studies that screened all patients prior to hospital discharge, the rate of asymptomatic DVT was 10.9% (2.0% to 20.2%). The most common risk factors identified for VTE were endoprosthetic replacements, hip and pelvic resections, presence of metastases, surgical procedures taking longer than three hours, and patients having chemotherapy. Mean incidence of VTE with and without chemical prophylaxis was 7.9% (1.1% to 21.8%) and 8.7% (2.0% to 23.4%; p = 0.11), respectively. No difference in the incidence of bleeding or wound complications between prophylaxis groups was reported. Conclusion Current evidence is limited to guide clinicians. It is our consensus opinion, based upon logic and deduction, that all patients be considered for both mechanical and chemical VTE prophylaxis, particularly in high-risk patients (pelvic or hip resections, prosthetic reconstruction, malignant diagnosis, presence of metastases, or surgical procedures longer than three hours). Additionally, the surgeon must determine, in each patient, if the risk of haemorrhage outweighs the risk of VTE. No individual pharmacological agent has been identified as being superior in the prevention of VTE events. Cite this article: Bone Joint J 2020;102-B(12)1743:–1751.

BackgroundDedifferentiated chondrosarcomas (CS) are a high-grade variant of CS that confers a 5-year survival of around 10–24%. Dedifferentiated CS arising from the pelvis confers an even worse prognosis.Questions(1) What is the prognosis of patients with dedifferentiated CS of the pelvis? (2) Do wide margins or type of surgical intervention influence outcome? (3) Does the use of adjuvant therapy affect outcome?MethodsPatients were retrospectively reviewed from a prospectively collated musculoskeletal oncology database from 1995 to 2016. Thirty-one cases of dedifferentiated CS arising from the pelvis were included. Wide margins were defined as greater than 4 mm. The mean age was 55.6 years (range 33 to 76 years) and there were 19 males (61.3%) and 12 females (38.7%).ResultsThe disease presented at a locally or systemically advanced stage in 13 patients (41.9%). Eighteen patients (58.1%) underwent surgery with curative intent. Overall survival at 12 months was 15.4% for patients treated with palliative intent and 50% for those treated with surgery. In the surgical group, there were higher rates of disease-free survival in patients who underwent hindquarter amputation and those who received wide surgical margins (p = 0.047 and p = 0.019, respectively). Those who underwent hindquarter amputation were more likely to achieve wide margins (p = 0.05). Time to recurrent disease (local or systemic) was always less than 24 months. No hindquarter amputation for recurrent disease resulted in disease-free survival. No patient who received adjuvant therapy for palliative or recurrent disease had disease control.ConclusionsPelvic dedifferentiated CS often presents at an advanced local or systemic stage and confers a poor prognosis. Achieving wide surgical margins (> 4 mm) provided the highest rate of long-term disease-free survival. Failing to achieve wide margins results in rapid disease recurrence, conferring deleterious consequences.