Orthopaedic research in low-income countries: A bibliometric analysis of the current literature

Abstract – Background: To perform a bibliometric analysis and quantify the amount of orthopaedic and trauma

literature published from low-income countries (LICs).

Methods and methods: The Web of Science database was utilised to identify all indexed orthopaedic journals. All

articles published in the 76 orthopaedics journals over the last 10 years were reviewed, to determine their geographic

origin.

Results: A total of 131 454 articles were published across 76 orthopaedic journals over the last 10 years. Of these,

132 (0.1%) were published from LICs and 3515 (2.7%) were published from lower middle-income countries (LMICs);

85.7% (n = 112 716) of published orthopaedic research was undertaken in a high-income setting. The majority of the

studies (n = 90, 74.4%) presented level IV evidence. Only 7.4% (n = 9) were high-quality evidence (level I or II). Additionally, the majority of research (74 articles, 56%) was published in partnership with high-income countries (HICs).

Conclusions: There is a stark mismatch between the publication of scientific reports on orthopaedic research and the

geographical areas of greatest clinical need. We believe there is an urgent need for orthopaedic research to be carried

out in low-income settings to guide treatment and improve outcomes, rather than assuming that evidence from highincome settings will translate into this environment.