Barriers to orthopedic surgery research productivity in Saudi Arabia

Research productivity is a cornerstone of academic medicine, driving evidence-based practice, innovation, and professional advancement. In surgical specialties such as orthopedics, active research engagement is essential to improving patient outcomes and advancing clinical techniques. However, despite notable progress in Saudi Arabia's medical research landscape, orthopedic research output remains limited and concentrated within a few institutions. Understanding the barriers that hinder orthopedic surgeons from conducting research is therefore crucial to strengthening national research capacity and aligning with Saudi Vision 2030's goal of fostering scientific excellence.

To identify the barriers that limit research productivity among orthopedic surgeons in Saudi Arabia and explore the goals and motivations influencing their engagement in research across different subspecialties and levels of practice.

We used a descriptive, cross-sectional, quantitative design, employing a structured online questionnaire distributed to 105 orthopedic surgeons across Saudi Arabia. The questionnaire was adapted from validated tools and reviewed for validity. Participants reported practice patterns, research activity, and barriers to productivity. Associations between variables were analyzed using univariate and multivariate methods.

A total of 105 orthopedic surgeons completed the survey. A statistically significant association was found between prior research experience and having served as a primary investigator within the past 5 years. Additionally, a highly significant association was found with co-authorship in the last 5 years (P < 0.001), as 52 participants (55.3%) had contributed as co-authors at least once. However, there was no significant association between prior research experience and factors such as allocated research time (P = 0.280), level of practice (P = 0.147), years in practice (P = 0.826), or the number of patients seen per week (P = 0.885). Univariate analysis revealed several barriers to research productivity: (1) Insufficient research time (71; 67.6%); (2) Lack of research assistants (57; 54.3%); (3) Inadequate research training (48; 45.7%); (4) Lack of funding (42; 40%); (5) Lack of research collaboration (39; 37.1%); (6) Lack of reward/incentive (38; 36.2%); and (7) No personal interest (20; 19.04%).

Addressing protected time, support staff, and research training may enhance orthopedic research productivity. This study highlights key institutional and educational gaps that can guide policy reforms and strengthen national orthopedic research capacity.