A bibliometric analysis of the top 100 most-cited shoulder arthroscopy patents

Despite significant technological advancement in the field of shoulder arthroscopy, there remains limited evaluation of the evolution and categorization of shoulder arthroscopy patents. This bibliometric and patent analysis was performed to address this gap by systematically evaluating the most influential shoulder arthroscopy patents. The primary purpose of this study was to characterize the 100 most-cited shoulder arthroscopy patents by category of innovation and to analyze differences in citation metrics, including age-adjusted citation rates, and temporal trends across categories.

The Lens patent database was searched for patents containing "arthroscop∗" and "shoulder" in titles, abstracts, or claims, restricted to medical patents using Cooperative Patent Classification code A61. Patents were manually screened for relevance, ranked by forward citations, and the top 100 categorized into 6 groups: Arthroscopic Instruments, Fixation, Implants, Orthobiologic/Pharmacologic/Regenerative Medicine (OPR), Access and Retraction, and Computer-guided Systems. Non-parametric statistics compared forward citation counts and age-adjusted citation rates across categories. Significance was set at P < .05.

Of 579 unique patents identified, 261 remained after screening. Among the top 100, median forward citation count was 97 (interquartile range: 26-188). Arthroscopic Instruments were most frequent (42%), followed by Fixation (19%), OPR (17%), Implants (15%), Access and Retraction (5%), and Computer-guided Systems (2%). Fixation patents had the highest median forward citation count (177, interquartile range: 92-308, P = .004) and highest median age-adjusted citation rate (8.40 citations/year, P = .002). Temporal analysis revealed a significant association between time period and category distribution (P = .005), with Arthroscopic Instruments decreasing from 82% in the ≤ 1995 period to 31% in 2006-2015, while Implants (0%-23%) and OPR (5%-23%) increased. At analysis, 46% of patents were expired, 41% active, and 13% inactive.

Arthroscopic Instruments and Fixation patents comprised more than half of the top 100 most-cited shoulder arthroscopy patents. Fixation patents demonstrated the highest citation impact, including the highest age-adjusted citation rate, a metric that showed no significant correlation with patent age and may therefore more reliably reflect technological influence independent of temporal bias. Age-adjusted citation rates and temporal trend analyses revealed a shifting patent landscape, with increasing innovation in Implants and OPR categories over time. This bibliometric and patent analysis characterizes the shoulder arthroscopy patent landscape and may serve as a resource for researchers, clinicians, and industry stakeholders seeking to identify areas of continued innovation.