Influential Articles on Pediatric and Adolescent Anterior Cruciate Ligament Injuries: A Bibliometric Analysis
Sachin Allahabadi1, Sonali E Feeley1, Drew A Lansdown1
1Department of Orthopaedic Surgery, University of California, San Francisco; San Francisco, California, USA.
Insights
Highly cited pediatric anterior cruciate ligament (ACL) research is recent but often lacks high-quality evidence. More citations did not correlate with better study quality, indicating a need for improved research standards in pediatric ACL injury literature.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Pediatric Traumatology
Background:
- Understanding of pediatric anterior cruciate ligament (ACL) injuries has advanced significantly.
- Citation analysis is a key method for evaluating the impact of influential research.
Purpose of the Study:
- Identify and characterize the 50 most cited and recent influential articles on pediatric and adolescent ACL injuries.
- Examine publication trends and assess the correlation between citation counts and study quality.
Main Methods:
- Cross-sectional study utilizing Web of Science and Scopus databases.
- Collected top 50 cited articles and recent high-impact papers, analyzing citation density.
- Assessed evidence level and methodological quality using modified Coleman Methodology Score, modified Jadad scale, and MINORS.
Main Results:
- Top cited articles averaged 117.5 citations, with 80% published after 2000.
- Most studies were Level 4 evidence (64.3%), with no Level 1 evidence found.
- Strong correlation found between higher citations and lower methodological quality (modified Jadad scale).
Conclusions:
- Influential pediatric ACL injury articles are recent but predominantly feature lower evidence levels and methodological quality.
- Higher methodological quality did not correlate with increased citation impact.
- Future research should prioritize improving study design and evidence quality in pediatric ACL injury literature.
Background:
The understanding of pediatric anterior cruciate ligament (ACL) injuries and optimal treatment has evolved significantly. Influential articles have been previously evaluated using article citations to determine impact.
Purpose:
To identify and characterize the 50 most cited and recent influential articles relating to pediatric and adolescent ACL injuries, to examine trends in publication characteristics, and to evaluate correlations of study citations with quality of evidence.
Study Design:
Cross-sectional study.
Methods:
The top 50 most cited articles on pediatric and adolescent ACL injuries were gathered using the Web of Science and Scopus online databases by averaging the number of citations from each database. Articles from recent years were also aggregated and sorted by citation density (citations/year). Publication and study characteristics were recorded. Level of evidence and methodologic quality were assessed where applicable using the modified Coleman Methodology Score (mCMS), modified Jadad scale, and Methodological Index for Non-Randomized Studies (MINORS). Spearman correlation was used to evaluate the association between citation data and level of evidence or methodologic quality scorings.
Results:
The top 50 cited papers had a mean of 117.5 ± 58.8 citations (range, 58.5-288.5 citations), with a mean citation density of 9.4 ± 5.4 citations per year (range, 2.9-25.8 citations/year); 80% were published in 2000 or later, and 6% were considered basic science. Articles were mainly level 4 evidence (27/42; 64.3%), and none was level 1. There were moderate, significant associations between publication year and level of evidence (r S = -0.45; P = .0030) and citation density and publication year (r S = 0.59; P < .001). Mean methodologic quality scores were as follows: mCMS, 53 ± 7.2 (range, 39-68); modified Jadad scale, 3.2 ± 1.1 (range, 2-6); and MINORS, 11.2 ± 3.2 (range, 6-20). There was a significant, strong correlation between rank of mean citations and modified Jadad scale (r S = 0.76; P < .0001), suggesting poorer score associated with more mean citations.
Conclusion:
Influential articles on pediatric and adolescent ACL injuries were relatively recent, with a low proportion of basic science-type articles. Most of the studies had a lower evidence level and poor methodologic quality scores. Higher methodologic quality did not correlate positively with citation data.
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