Purpose To determine the 50 most frequently cited studies in the orthopaedic shoulder arthroscopy literature and to conduct a bibliometric analysis of these studies. Methods The Clarivate Analytics Web of Knowledge database was used to gather data and metrics using Boolean queries to capture all possible iterations of shoulder arthroscopy research. The search list was sorted so that articles were organized in descending order based on the number of citations and included or excluded based on relevance to shoulder arthroscopy. The information extracted for each article included author name, publication year, country of origin, journal name, article type, and the level of evidence. Results For these 50 studies, the total number of citations was calculated to be 13,910, with an average of 278.2 citations per paper. The most-cited article was cited 1134 times, whereas the second- and third-most cited articles were cited 920 and 745 times, respectively. All 50 articles were published in English and came from 7 different orthopaedic journals. The United States was responsible for most of the included articles (31), followed by France (9) and Japan (3). Conclusions The majority of the most-cited articles in shoulder arthroscopy are case series and descriptive studies originating from the United States. In addition, more than one half of the top 50 most-cited studies were published after 2004, which suggests that article age may be less important in the accumulation of citations for a rapidly growing field like shoulder arthroscopy. Clinical Relevance The top 50 most-cited studies list will provide researchers, medical students, residents, and fellows with a foundational list of the most important and influential academic contributions to shoulder arthroscopy.
Purpose: Owing to the nature of orthopaedic surgery, occupational hazards and musculoskeletal pain (MSP) are inherent. These hazards have been well-documented among practicing orthopaedic surgeons, but there remains a paucity of data regarding MSP among orthopaedic surgery residents. The purpose of this study was to identify the prevalence and quantify the extent of work-related MSP among orthopaedic surgical residents. We also sought to analyze resident attitudes, beliefs, and behaviors regarding surgical ergonomics. Methods: An online survey was sent to 78 orthopaedic surgery resident program directors to be distributed to residents within their programs. The survey included three main sections: symptoms by body part, attitudes/beliefs/behaviors regarding surgical ergonomics, and finally demographics. Pain was reported as using the 0 to 10 Numeric Rating Scale, with 0 = no pain and 10 = maximum pain. Several questions about resident well-being were assessed using the Maslach Burnout Inventory. Results: Seventy-six orthopaedic surgery residents completed the survey, 72% men and 28% women. Most residents (97%) experience procedural-related MSP. Average pain scores of all residents was 3.52/10. Notable levels of MSP (≥4/10) were most common in the lower back (35%), neck (29.7%), and feet (25.7%). A positive association exists between higher MSP and lower work satisfaction ( P = 0.005), burnout ( P = 0.04), and callousness toward others ( P < 0.0001). MSP has notable impact on resident behaviors including over-the-counter medication use, stamina, concentration, and degree of irritability. Conclusion: The prevalence of MSP among orthopaedic surgical residents is extremely high. Our study demonstrates that MSP has a notable impact on resident concentration, degree of irritability, and other burnout symptoms. The results of this study highlight the importance of limiting compromising procedural positions, ergonomic optimization, and increasing the awareness of the importance of ergonomics among residents. This could have future implications on productivity and career longevity.
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