The Influence of Media Type and Posting Time on Altmetric Engagement of Orthopaedic Surgery Journals on X

Digital promotion of orthopaedic research is increasingly associated with scholarly visibility yet the influence of specific social media posting characteristics on online attention remains unclear. The Altmetric Attention Score (AAS) is a weighted score that measures the amount of attention a study has received. The score is based on three factors: the volume of mentions, the medium the mention came from, and the author of the mention. In orthopaedic research, a higher AAS is correlated with higher citation rates. The purpose of this study was to examine the relationship between AAS and the presence of various types of multimedia in posts on X by orthopaedic surgery journals and the time posts were made.

Data were collected from the X accounts of the British Journal of Sports Medicine (BJSM), Journal of Bone and Joint Surgery (JBJS), Arthroscopy, Journal of Arthroplasty, American Orthopedic Society for Sports Medicine Journals (AOSSM), and Journal of the American Academy of Orthopaedic Surgeons (JAAOS) over two separate periods, January 1, 2023, to June 31, 2023, and July 1, 2024, to December 31, 2024. Media types were classified into the following categories: no media, text only, simple media, infographics, and videos. To analyze the effect of post time on AAS score, posts were grouped into three different time groups: 10 pm to 5:59 am, 6 am to 1:59 pm, and 2 pm to 9:59 pm. Statistical analysis for data sets with three or more groups was done with an Analysis of Variance (ANOVA) with post hoc t-tests performed when statistical significance was found. For data sets with only two groups, t-tests were done.

One-way ANOVA results showed a significant difference in the average AAS between media types for the Journal of Bone and Joint Surgery (JBJS) in the 2024 period (P < 0.01) and in Arthroscopy for both the 2023 and 2024 periods (P < 0.0001 and P < 0.05, respectively). Post hoc t-tests showed a significant difference in average AAS between simple media and infographics for JBJS in 2024 with average AAS scores of 2.81 and 11, respectively (P < 0.001). In 2023, Arthroscopy showed significant differences in the average AAS of simple media vs infographics, simple media vs text only, and infographics vs no media (P < 0.0001, 0.0001, and 0.05, respectively). In 2024, Arthroscopy showed significant differences in average AAS for simple media vs infographics, videos vs infographics, and videos vs text only with P < 0.05, 0.005, and 0.05, respectively. For the American Orthopaedic Society for Sports Medicine (AOSSM) journals, t-tests showed a statistically significant difference in average AAS between posts made from 6 am to 1:59 pm and posts made from 2 pm to 9:59 pm with a P < 0.05 and average AAS of 12.9 and 74.5, respectively.

Although results were not consistent across all journals, one trend was the increased AAS of infographics. This repeated success suggests a promising avenue for orthopaedic journals to improve the reach of their studies by increasing the utilization of infographics. Time posted did not seem to have a notable effect on AAS, but for the AOSSM Sports Medicine journals, the time frame of 2 pm to 9:59 pm may be an optimal time to maximize reach. Future studies with larger data sets and the development of an objective media classification system may provide an avenue toward strengthening the findings of this study and developing more precise strategies for orthopaedic journals to optimize their social media presence.