The Current State of International Academic Partnerships in Orthopaedic Surgery Between High-Income and Low and Middle-Income Countries: A Systematic Review

Michael J Flores; Madeline C MacKechnie; Kelsey E Brown; Jamieson M O'Marr; Patricia Rodarte; Adrienne Socci; Theodore Miclau

doi:10.2106/JBJS.OA.24.00033

The Current State of International Academic Partnerships in Orthopaedic Surgery Between High-Income and Low and Middle-Income Countries: A Systematic Review

JB JS Open Access. 2024 Sep 13;9(3):e24.00033. doi: 10.2106/JBJS.OA.24.00033. eCollection 2024 Jul-Sep.

Authors

Michael J Flores^{1

2

3}, Madeline C MacKechnie^{2

3}, Kelsey E Brown^{2

3}, Jamieson M O'Marr^{1

2

3}, Patricia Rodarte^{2

3}, Adrienne Socci¹, Theodore Miclau^{2

3}

Affiliations

¹ Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut.
² Department of Orthopaedic Surgery, Institute for Global Orthopaedics and Traumatology, University of California, San Francisco, San Francisco, California.
³ Department of Orthopaedic Surgery, Institute for Global Orthopaedics and Traumatology, Orthopaedic Trauma Institute, University of California San Francisco, Zuckerberg San Francisco General Hospital, San Francisco, California.

Abstract

Background: Orthopaedic academic partnerships between high-income countries (HICs) and low and middle-income countries (LMICs) are an effective method to increase research and scholarly support. The purpose of this study was to perform a systematic literature review of the current state of partnerships worldwide and assess the quality, quantity, and content of their research output.

Methods: A systematic review was conducted using 4 academic databases: PubMed, MEDLINE, Embase, and CENTRAL. Article eligibility criteria included articles published between January 2017 and 2022, with orthopaedic authors from at least 1 HIC and LMIC. Articles related to global orthopaedic surgery with exclusively HIC or LMIC authors were excluded.

Results: The database search yielded 25,928 articles, and after deduplication, 21,145 articles were included in the screening. After title and abstract screening, 408 articles underwent full-text review for eligibility. The final list of eligible articles for extraction included 310 publications in 127 journals. Published articles increased over time (46 in 2017 to 88 in 2021) and were most commonly published in the Journal of Bone and Joint Surgery (20, 6.5%). Open-access articles (203, 65.5%) had a significantly greater Journal Citation Indicator (p = 0.024) than non-open-access articles. Most studies (40.7%) were observational, with few (3.6%) randomized controlled trials. Orthopaedic trauma (38.1%) was the most common subspecialty, followed by spine (14.8%) and pediatrics (14.2%). Most partnerships were sponsored by North American authors in 65 LMICs, primarily China, India, and the sub-Saharan African region.

Conclusion: This study identified 310 articles published by orthopaedic international academic partnerships in 106 countries over the past 5 years, demonstrating that collaborations between LMIC/HIC partners nearly doubled over the study period. Sixty-five percent of the articles were published in open-access journals.

Publication types

Review