Bibliometric Analysis of the Top 100 Most Cited Articles on Wrist Arthroscopy

Abstract

Background: Over the past few decades, more articles have been published about wrist arthroscopy. The purpose of this study was to identify and analyze the 100 most cited articles about wrist arthroscopy.

Methods: The 100 most cited articles were analyzed using the wrist arthroscopy as a keyword on the Web of Science database. Original articles, reviews, clinical trials, and cadaveric studies were included in the study. We recorded and analyzed the following information: Article title, first author, year of publication, journal of publication, the total number of citations, level of evidence, article language, country, institution, and the main topic of study.

Results: The number of citations ranged from 35 to 180 (mean, 64.74). The total number of citations was 6,474. Among the articles examined, the most prolific country was the United States of America (USA). The Journal of Hand Surgery- American Volume was the journal with the most number of publications and the most cited articles. The main topics that were most analyzed and underlined were the diagnostic comparison of Magnetic resonanas imaging and arthroscopy and the diagnosis and treatment of triangular fibrocartilage complex.

Conclusions: As a result, wrist arthroscopy continues to develop, and it is a subject that is open for new studies. More comprehensive and up-to-date randomised controlled studies comparing the benefit of wrist arthroscopy or open surgery for wrist pathologies will demonstrate the importance of arthroscopy in the diagnosis and treatment of problems related to this topic.

Introduction

At the current age, where the limits of computer and internet technologies are challenged, the virtual environment is gradually becoming the main source for researchers to access information. Nonetheless, easy access to the information leads to an increase in incorrect and incomplete information. Hence, academic portals that provide quality information at international standards have become of great importance. Citation analysis helps us make a decision about the quality of an academic publication [1, 2]. In the orthopedic literature, there are different studies involving citation analyses on various topics [3–6]. There is no study involving citation analysis about wrist arthroscopy in the literature. In general, there is one previous publication that scanned all cases of wrist arthroscopy [7]. With the widespread use of arthroscopic procedures involving narrow joints, wrist arthroscopy has been used in the diagnosis and treatment of wrist diseases for 30 years; and its importance is gradually increasing [8, 9]. Wrist arthroscopy is frequently used for diagnosis and simultaneous treatment in triangular fibrocartilage complex (TFCC), ganglion cysts of the wrist, distal radial and carpal bone fractures, intercarpal ligament injuries [10–12].

This study aims to perform a bibliometric analysis on the 100 most cited articles about the diagnosis and treatment of wrist arthroscopy.

Methods

The Web of Science Core Collection is recognized as the most suitable online database for bibliometric analysis. The search was performed using the term wrist arthroscopy in the search bar under the title category or the topic category on January 2021 including all articles from 1990 to 2020 using the Web of Science platform. After search the database, all articles were ranked from the most cited to the least cited. Articles not related to the diagnosis and treatment process of wrist arthroscopy were excluded. We recorded and analyzed the following information: article title, first author, year of publication, journal of publication, total number of citations, level of evidence, article language, country, institution, and main topic of study.

Results

A total of 790 publications related to wrist arthroscopy were identified. The 100 highest cited papers according to number of citations can be seen in Table 1. The number of citations ranged from 35 to 180 (average, 64.74). The total number of citations was 6,474. Of the 100 articles, 37 (37%) were published between 1990 and 2000, 52 (52%) were published between 2000 and 2010, and only 11 (11%) were published between 2010 and 2020. The year with the highest total number of citations was 2012 (499) Table 2. Among the articles, 96 were written in English, and 4 were written in German.

Table 1

List of the top 100 cites articles on wrist arthroscopy with citations
Rank	Article	Total citations
1	Triangular fibrocartilage tears	180
2	Peripheral tears of the triangular fibrocartilage complex cause distal radioulnar joint instability after distal radial fractures	140
3	Chronic wrist pain: spin-echo and short tau inversion recovery MR imaging and conventional and MR arthrography	135
4	Magnetic resonance imaging and miniarthroscopy of metacarpophalangeal joints - Sensitive detection of morphologic changes in rheumatoid arthritis	119
5	The unar fovea sign for defining ulnar wrist pain: An analysis of sensitivity and specificity	116
6	Comparison of synovial tissues from the knee joints and the small joints of rheumatoid arthritis patients - Implications for pathogenesis and evaluation of treatment	113
7	Scapholunate ligament reconstruction using a bone-retinaculum-bone autograft	111
8	Epidemiology of musculoskeletal upper extremity ambulatory surgery in the United States	107
9	Sport injuries: a review of outcomes	106
10	Wrist ligament tears: Evaluation of MRI and combined MDCT and MR arthrography	101
11	Alefacept treatment in psoriatic arthritis - Reduction of the effector T cell population in peripheral blood and synovial tissue is associated with improvement of clinical signs of arthritis	101
12	The utility of high-resolution magnetic resonance imaging in the evaluation of the triangular fibrocartilage complex of the wrist	100
13	Comparison of 3-T MRI and Arthroscopy of Intrinsic Wrist Ligament and TFCC Tears	98
14	Arthroscopic repair of triangular fibrocartilage complex tears	95
15	Distal radioulnar instability is an independent worsening factor in distal radial fractures	90
16	The ulnocarpal stress test in the diagnosis of ulnar-sided wrist pain	90
17	Isolated tears of the triangular fibrocartilage: Management by early arthroscopic repair	89
18	Evaluation of chronic wrist paın by arthrography, arthroscopy, and arthrotomy	89
19	Ulnar shortening for triangular fibrocartilage complex tears associated with ulnar positive variance	88
20	Arthroscopic resection of dorsal ganglion of the wrist	82
21	The scapholunate interosseous ligament in MR arthrography of the wrist: Correlation with non-enhanced MRI and wrist arthroscopy	81
22	Comparison of the findings of triple-injection cinearthrography of the wrist with those of arthroscopy	81
23	MR imaging diagnosis of triangular fibrocartilage pathology with arthroscopic correlation	79
24	Limitations of MR Imaging in the diagnosis of peripheral tears of the triangular fibrocartilage of the wrist	78
25	Prevalence of musculoskeletal disorders at the NFL combine-trends from 1987 to 2000	77
26	Magnetic resonance imaging of the wrist: Diagnostic performance statistics	77
27	Diagnostic comparison of 1.5 Tesla and 3.0 Tesla preoperative MRI of the wrist in patients with ulnar-sided wrist pain	76
28	Evaluation of the triangular fibrocartilage complex tears by arthroscopy, arthrography, and magnetic-resonance-imaging	75
29	Treatment of intra-articular fractures of the distal radius - Fluoroscopic or arthroscopic reduction?	74
30	Intercarpal ligament injuries associated with fractures of the distal part of the radius	74
31	The carpal ligaments in MR arthrography of the wrist: Correlation with standard MRI and wrist arthroscopy	74
32	A comparison of combined arthroscopic triangular fibrocartilage complex debridement and arthroscopic wafer distal ulna resection versus arthroscopic triangular fibrocartilage complex debridement and ulnar shortening osteotomy for ulnocarpal abutment syndrome	72
33	Internal derangement of the wrist: Indirect MR arthrography versus unenhanced MR imaging	72
34	New trends in arthroscopic management of type 1-B TFCC injuries with DRUJ instability	70
35	Ulnar impaction syndrome: MR imaging findings	70
36	Clinical comparison of arthroscopic versus open repair of triangular fibrocartilage complex tears	69
37	Results of acute arthroscopically repaired triangular fibrocartilage complex injuries associated with intra-articular distal radius fractures	68
38	Ulna-shortening osteotomy after failed arthroscopic debridement of the triangular fibrocartilage complex	68
39	Mr-imaging of anatomy and tears of wrist ligaments	67
40	Arthroscopic reduction versus fluoroscopic reduction in the management of intra-articular distal radius fractures	64
41	Direct MR arthrography of the wrist in comparison with arthroscopy: A prospective study on 125 patients	62
42	Intra-articular distal radius fractures: Arthroscopic assessment of radiographically assisted reduction	61
43	Lesions of the triangular fibrocartilage complex: MR findings with a three-dimensional gradient-recalled-echo sequence	61
44	Foveal TFCC Tear Classification and Treatment	60
45	Partial scapholunate ligament injuries treated with arthroscopic debridement and thermal shrinkage	59
46	Blatt's capsulodesis for chronic scapholunate dissociation	59
47	Interosseous ligament tears of the wrist: Comparison of multi-detector row CT arthrography and MR imaging	58
48	Arthroscopic repair of the triangular fibrocartilage complex	56
49	Peripheral tear of the triangular fibrocartilage: Depiction with MR arthrography of the distal radioulnar joint	55
50	New advances in wrist arthroscopy	54
51	Dry arthroscopy of the wrist: Surgical technique	54
52	Complications of wrist arthroscopy	54
53	Extrinsic carpal ligaments: Normal MR arthrographic appearance in cadavers	54
54	Applied anatomy of the superficial branch of the radial nerve	53
55	The role of arthroscopy in the treatment of intraarticular wrist fractures	53
56	Arthroscopic versus open dorsal ganglion excision: A prospective, Randomized comparison of rates of recurrence and of residual pain	52
57	Current concepts in wrist arthroscopy	52
58	Comparison between high-resolution MRI with a microscopy coil and arthroscopy in triangular fibrocartilage complex injury	52
59	Wrist arthroscopy for the treatment of ligament and triangular fibrocartilage complex injuries	52
60	Arthroscopically assisted reduction of intraarticular distal radial fractures	52
61	The radial sensory nerve - an anatomic study	52
62	Mr evaluation of triangular fibrocartilage complex tears in the wrist - comparison with arthrography and arthroscopy	52
63	Prospective Outcomes and Associations of Wrist Ganglion Cysts Resected Arthroscopically	51
64	3.0 T high-resolution MR imaging of carpal ligaments and TFCC	51
65	Results of repair of peripheral tears in the triangular fibrocartilage complex using an arthroscopic suture technique	51
66	Wrist arthrography versus arthroscopy: A comparative study of 150 cases	51
67	Comparison of Arthroscopic and Open Treatment of Septic Arthritis of the Wrist	49
68	A comparison of the findings of wrist arthroscopy and magnetic resonance imaging in the investigation of wrist pain	49
69	A comparison of magnetic resonance imaging and arthroscopy in the investigation of chronic wrist pain	49
70	Arthroscopic management of wrist triangular fibrocartilage complex injuries in the athlete	49
71	Intrinsic ligament and triangular fibrocartilage complex (TFCC) tears of the wrist: comparison of isovolumetric 3D-THRIVE sequence MR arthrography and conventional MR image at 3 T	48
72	Arthroscopy-assisted fracture fixation	48
73	Wrist arthroscopy - indıcations and results	48
74	Intrinsic ligament and triangular fibrocartilage complex tears of the wrist: comparison of MDCT arthrography, conventional 3-T MRI, and MR arthrography	47
75	Arthroscopic resection in the management of dorsal wrist ganglions: Results with a minimum 2-year follow-up period	47
76	Arthroscopic portals of the wrist - an anatomic study	46
77	The application of indirect reduction techniques in the distal radius: The role of adjuvant arthroscopy	45
78	Press test for office diagnosis of triangular fibrocartilage complex tears of the wrist	45
79	A comparison of CT arthrography of the wrist to findings during wrist arthroscopy	44
80	Chronic lunotriquetral instability – diagnosıs and treatment	44
81	MRI in the diagnosis of cartilage injury in the wrist	43
82	Percutaneous fixation of scaphoid fractures	43
83	Treatment of isolated injuries of the lunotriquetral ligament - A comparison of arthrodesis, ligament reconstruction and ligament repair	43
84	The effect of observer experience on magnetic resonance imaging interpretation and localization of triangular fibrocartilage complex lesions	43
85	Wrist ligament injuries: value of post-arthrography computed tomography	42
86	Diagnostic accuracy of plain radiographs and cineradiography in diagnosing traumatic scapholunate dissociation	40
87	Association between extrinsic and intrinsic carpal ligament injuries at MR arthrography and carpal instability at radiography: Initial observations	40
88	Early isolated triangular fibrocartilage complex tears: Management by arthroscopic repair	40
89	Diagnostic usefulness of synovial vascular morphology in chronic arthritis. A systematic survey of 100 cases	39
90	Arthroscopically Assisted Repair of Triangular Fibrocartilage Complex Foveal Tears	38
91	The Natural Course of Traumatic Triangular Fibrocartilage Complex Tears in Distal Radial Fractures: A 13–15 Year Follow-up of Arthroscopically Diagnosed but Untreated Injuries	38
92	Arthroscopic Treatment of Peripheral Triangular Fibrocartilage Complex Tears With the Deep Fibers Intact	38
93	Arthroscopic Treatment of Triangular Fibrocartilage Wrist Injuries in the Athlete	38
94	Standard wrist arthroscopy. Technique and documentation	37
95	Arthroscopically Assisted Reattachment of Avulsed Triangular Fibrocartilage Complex to the Fovea of the Ulnar Head	37
96	Triangular fibrocartilage injuries in pediatric and adolescent patients	37
97	Instability of the Distal Radioulnar Joint - an Overview of Clinical and Radiological Procedures Regarding their Efficacies	36
98	Arthroscopic Resection of Dorsal Wrist Ganglia: 114 Cases With Minimum Follow-Up of 2 Years	36
99	High-resolution MR imaging of triangular fibrocartilage complex (TFCC): comparison of microscopy coils and a conventional small surface coil	36
100	MRI versus arthroscopy in the diagnosis of scapholunate ligament injury	35

Table 2.

All articles were published in 28 different journals, with the Journal of Hand Surgery-American volume contributing the most 28 (28%), followed by Arthroscopy: Journal of Arthroscopic and Related Surgery 13 (13%), Radiology 7 (7), American Journal of Roentgenolgy 6 (6), Journal of Hand Surgery-British and Europan volume 5 (5%), Skeletal Radiology 5 (5%), The journal of Bone and Joint Surgery (American Volume) 4 (4%), Hand Clinics 4 (4%), Clinical Orthopedics and Related Research 3 (3%), Arthritis and Rheumatism 3 (3%), The journal of Bone and Joint Surgery (British Volume) 2 (2%), RoFo-Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren 2 (2%), Handchirurgie Mikrochirurgie Plastische Cirurgie 1 (1%), Operative Orthopädie und Traumatologie 1 (1%), Seminars in Arthritis and Rheumatism 1 (1%), American Journal of Sports Medicine 1 (1%), Clinical Radiology 1 (1%), Annals of Plastic Surgery 1 (1%), The Journal of Trauma Injury Infection and Critical Care 1 (1%), Knee Surgery, Sports Traumatology, Arthroscopy 1 (1%), Journal of Magnetic Resonance Imaging 1 (1%), Magnetic Resonance Imaging 1 (1%), Orthopedics 1 (1%), Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery 1 (1%), Journal of Computer Assisted Tomography 1 (1%), Clinical Anatomy 1 (1%), Radiographics 1 (1%), Medicine and Science in Sports Exercise 1 (1%), British Medical Bulletin 1 (1%), BMC Musculoskeletal Disorders 1 (1%), respectively.

According to the origins of the journals where the articles were published, there were 44 articles about orthopedics, 26 articles about radiology and nuclear medicine, 14 articles about sports science, 7 articles about surgery, and 4 articles about rheumatology. The remaining 5 articles were about emergency medicine, general internal medicine, anatomy and morphology, critical care medicine, and rehabilitation, respectively.

The most prolific years were 2001 with 9 articles published, followed by the years 2007 and 2008 with 8 articles published in each. There were articles from 18 different countries and 71 different institutes. The most productive institutes were Mayo Clinic from the United States of America (USA) with 8 publications; Wake Forest University, Yale University, and Brown University from the USA with 4 publications each (Table 3). In terms of country and region of origin, most articles were from the United States of America (51), which was followed by Germany (9), the United Kingdom (6), Japan (6), Switzerland (5), and Italy (4) (Table 4).

Table 3

Top contributing Institutions
Institution	Record Count
Mayo clinic	8
Wake Forest University	4
Brown University	4
Yale University	4
ChineseUniversity of Hong Kong	3
Nagoya University	3
Lund University	3
Heinrich-HeineUniversity of Dusseldorf	2
University of Amsterdam	2
Hospital for Special Surgery, New york	2
HokkaidoUniversity	2
University of Pennsylvania	2
University of Modena	2
Balgrist University Hospital	2
Others	57

Table 4.

The most cited article was the article by Cooney WP et al. published in the Journal of Hand Surgery-American Edition with 180 citations [13]. The most-cited author was Cooney, WP, who had published 2 articles (2%). The total number of citations associated with Cooney WP was 269. The topic of the most cited article included the diagnosis and treatment of TFCC (13).

Among the 100 most cited articles, 86 were identified as original articles, 6 were review articles, 7 were cadaveric studies and 1 was a clinical trial. Based on the criteria on level of evidence, 5 articles were providing Level I evidence, 14 articles providing level II evidence, 36 articles providing level III evidence, 36 articles providing level IV evidence, and 9 articles providing level V evidence.

Among the 100 most cited articles, the 5 most discussed main topics were as follows: 1) The use of Magnetic resonanas imaging (MRI), arthroscopy, and arthrography in the diagnosis of the wrist − 33 (33%), 2) The diagnosis and treatment of TFCC injuries − 24 (24%), 3) Arthroscopic intercarpal ligament repair − 11 (11%), 4) Arthroscopy-assisted fracture fixation − 10 ( 10%), and 5) Arthroscopic excision of the ganglion cysts on the wrist − 6 (6%).

Discussion

Wrist arthroscopy has been of increasing importance in the arthroscopy branch of orthopedics since the day it was first defined. New techniques have constantly been defined, and new treatment procedures are created [14]. In the present study, our aim was to analyze the most cited articles in this developing field and to create a basic resource for the orthopedics community.

In the present study, we performed a bibliometric analysis on the articles about wrist arthroscopy, which were published between 1990 and 2020 [15, 16]. The earliest article was published by Cerofolini E. et al. in 1990 [17]. The highest number of publications were made between 2000 and 2010. The interest in arthroscopy increased with the first publication in, leading to an increase in the need for research on wrist arthroscopy. Accordingly, the number of publications also increased.

Looking at the articles analyzed, the most studied topic was the diagnostic value and comparison of MRI and arthroscopy in wrist pathologies. Other most discussed topics were interventional procedures such as the treatment of TFCC injuries, intercarpal ligament repair, and fracture fixation. Of the articles, 44 (44%) were published in the journals of orthopedics, and 26 (26%) were published in the journals of radiology. These results indicate that the basic studies on the wrist are diagnostic, and there is an increasing trend in the use of interventional procedures in wrist arthroscopy. When we looked up the articles concerning comparing the benefit of wrist arthroscopy over either open surgery or non operative management of wrist pathology, arthroscopy is superior to open surgery especially in TFCC repair, intercarpal ligament repair and diagnosis and treatment of joint surface pathologies.

As demonstrated in our results, the USA was the country where most articles were published, similar to the majority of previous bibliometric analyses[18–20]. The limited contribution from Africa, South America, and Australia may be due to the fact that their current publications are not listed in this database, or are not highly cited. The institute, where the highest number of studies were conducted, was Mayo Clinic. When all results are examined, it was observed that there were contributions to this subject from 71 different institutes in 18 different countries. This result indicates that wrist arthroscopy is a popular field of interest worldwide, which requires further research.

The most cited article was the original article titled 'Triangular Fibrocartilage Tears' by Cooney WP et al., which was published in the Journal of Hand Surgery-American Edition, with 180 citations[13]. The Journal of Hand Surgery-American Edition was the journal with the highest number of citations, and the journal that published the highest number of articles. The underlying reason for this high scientific contribution may be having a higher gross national product, receiving more research support, and having more senior researchers in the USA [16].

Our study has several limitations. First of all, the number of citations alone cannot determine the importance of an article. We may have excluded many quality studies from the analysis due to the low number of citations. Only published articles were included in the study while meeting records, textbooks, academic presentations, and lectures were excluded. We only searched the Web of Science database; we did not search the Pubmed, Medline, or Embase databases. Nonetheless, we believe that Web of Science is more reliable compared to the other databases in terms of content, quality, and transparency. We observe that the most cited articles are the articles with old dates. On the other hand, since the number of citations of newly published articles will be determined over time, they cannot be analyzed at this time. This may have caused us to exclude many high-quality articles in the study.

Conclusions

The present study will shed light on the developmental stages of wrist arthroscopy over a 30-year period. In conclusion, wrist arthroscopy is a subject that is open to improvement among the wrist pathologies in terms of both diagnosis and treatment, and it requires further research. This study reports the basic information about published articles on wrist arthroscopy and so is of particular relevance to a practicing surgeon and will help with decision making related to the treatment of wrist pathology by arthroscopy of otherwise. Further randomised controlled studies concerning arthroscopic or open surgery for this subject to be conducted on the wrist joint would provide easier and more applicable solutions about the pathologies of this region.

Abbreviations

TFCC: Triangular fibrocartilage complex; Magnetic resonance imaging: MRI; United States of America: USA

Declarations

Authors’ contributions

NG and VK drafted the manuscript and revised it critically for important intellectual content. NG analyzed and interpreted the data. NG and VK contributed substantially to the conception and design of the study. All authors read and approved the final manuscript.

Authors’ information

Not applicable

Funding

The authors received no financial support for the research, authorship, and/or publication of this article

Availability of data and materials

Data requests are available from the corresponding author

Etchical approval

The study does not need institutional review board. The study does not contain any human or animal parts.

Consent for publication

Not applicable.

Declaration of conflicting interests

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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