1338 THE JOURNAL OF BONE AND JOINT SURGERY  ANNOTATION The 100 classic papers of orthopaedic surgery A BIBLIOMETRIC ANALYSIS J. C. Kelly, R. W. Glynn, D. E. O’Briain, P. Felle, J. P. McCabe From National University of Ireland, Galway, Republic of Ireland  J. C. Kelly, MBBCh, BAO, IMRCS, Research Registrar  R. W. Glynn, MBBCh, BAO, BSc, Research Registrar  D. E. O’Briain, MBBCh, BAO, IMRCS, Research Registrar  J. P. McCabe, MBBCh, BAO, MCh, FRCSI, FRCS(Orth), Consultant Orthopaedic Surgeon Department of Surgery, Clinical Sciences Institute, Costello Road, National University of Ireland, Galway, Ireland.  P. Felle, MBBCh, BAO, BSc, MSc, Director Department of Healthcare Informatics, College of Life Sciences, School of Medicine University College, Dublin, Belfield, Dublin 4, Ireland. Correspondence should be sent to Mr J. C. Kelly; e-mail: johncokelly@gmail.com ©2010 British Editorial Society of Bone and Joint Surgery doi:10.1302/0301-620X.92B10. 24867 $2.00 J Bone Joint Surg [Br] 2010;92-B:1338-43. The credibility and creativity of an author may be gauged by the number of scientific papers he or she has published, as well as the frequency of citations of a particular paper reflecting the impact of the data on the area of practice. The object of this study was to identify and analyse the qualities of the top 100 cited papers in orthopaedic surgery. The database of the Science Citation Index of the Institute for Scientific Information (1945 to 2008) was used. A total of 1490 papers were cited more than 100 times, with the top 100 being subjected to further analysis. The majority originated in the United States, followed by the United Kingdom. The top 100 papers were published in seven specific orthopaedic journals. Analysis of the most-cited orthopaedic papers allows us a unique insight into the qualitites, characteristics and clinical innovations required for a paper to attain ‘classic’ status. A citation is an alphanumeric expression which acknowledges the relevance given by the author to the work of others on a topic of dis- cussion in which the citation appears. The pri- mary objective of a citation is to credit other authors with ideas and innovations about which they have previously published. It is an act of intellectual honesty. Citation analysis is a bibliometric process which describes the means of analysing the citation history of pieces of published data. The frequency of cita- tion has numerous implications for both authors and journals. The greater the citation history of authors, the more reputable they become in their chosen area of practice. The more cited an article from a particular journal, the greater the impact factor of that publica- tion. 1 Although its use brings problems 2 it is widely accepted that this is the best method of judging the merits of specific journals. 3 The impact factor is often used to determine the importance of a given journal in its specific field of interest, and has emerged as a marker of the quality and rank of the journal. It is determined from the ratio of the number of citations in the current year to articles pub- lished in the journal in the two preceding years, divided by the number of citable items pub- lished in the same two years. 4-6 A number of recent studies have attempted to generate ‘best of’ lists in specialties, such as gen- eral surgery, 7 plastic surgery, 8 dermatology, 9 otolaryngology, 10 paediatric orthopaedics 11 and critical care medicine. 12 These articles have allowed a more in-depth understanding of the characteristics required of a piece of research in order for it to attain the citation quotient necessary to attain ‘classic’ status. This study focuses exclusively on the most-cited articles in journals dedicated to orthopaedic surgery. Materials and Methods The database of the Science Citation Index of the Institute for Scientific Information from 1945 to 2008 was examined to identify the 100 most frequently cited papers from 15 of the most respected journals dedicated to ortho- paedic surgery (Table I). The choice of journals analysed was based on previous similar Table I. Orthopedic surgery journals analysed 1 Acta Orthopaedica Scandinavia 2 American Journal of Sports Medicine 3 Arthroscopy 4 Clinical Orthopaedics and Related Research 5 European Spine Journal 6 Foot and Ankle International 7 Journal of Arthroplasty 8 Journal of Bone and Joint Surgery (Am) 9 Journal of Bone and Joint Surgery (Br) 10 Journal of Orthopaedic Research 11 Journal of Paediatric Orthopaedics 12 Journal of Shoulder and Elbow Surgery 13 Knee Surgery Sports Traumatology Arthroscopy 14 Orthopedic Clinics of North America 15 Spine