A Systematic Review of Retracted Publications in Clinical Orthopaedic Research.

Background: Retracted publications are an often-overlooked issue affecting the scientific community, and recent data confirms the overall number of retracted publications is rising. While this has previously been looked at within orthopaedic surgery, a contemporary understanding of retractions is required due to the rapid expansion in publications. Our study aimed to assess the retracted publications within clinical orthopaedic research to evaluate for characteristics and trends.

Methods: A systematic review was conducted on December 14, 2023, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. There were 4 databases that were queried to identify retracted publications in clinical orthopaedics that assessed operative and nonoperative orthopaedic interventions (excluding basic science). Articles were independently screened by 2 reviewers; those meeting the inclusion criteria were evaluated for various characteristics, including reasons for retraction based on Committee on Publication Ethics guidelines.

Results: There were 233 studies that met the inclusion criteria and were retracted between January 1, 1990, and December 14, 2023. Clinical orthopaedics represented 1.18% of all retracted publications identified through PubMed over this period. There were 87 articles that were retracted in 2023, up from 17 in 2022 (a 412% increase). Retracted studies were published in journals with 2022 impact factors up to 9.3, with an average of 3.1 (SD [standard deviation] 1.9). A total of 39.5% of the retracted studies were published in orthopaedic journals, and 60.9% of the retracted articles were published in exclusively open-access journals. The mean time from electronic publication to retraction was 2.1 years (SD 2.2). Retracted articles have been cited up to 180 times (mean 8.6; SD 20). Reasons for retraction included misconduct (45.9%), plagiarism (11.6%), redundant publication (11.6%), unethical research (10.3%), error (9.4%), and others (10.7%).

Conclusions: The prevalence of retractions in the clinical orthopaedic literature is increasing. Clinical research is the basis for clinical practice guidelines, the gold standard for informing medical decision-making. Retractions may be one harbinger of lower-quality publications; researchers, institutions, and journals together play important roles in maintaining scientific integrity.