Bibliometric Mapping of Retracted Orthopaedics Publications (1986-2025): Evidence from the Retraction Watch Database

INTRODUCTION

Retractions represent a vital corrective mechanism in scholarly communication, serving to remove or flag published research that contains unreliable data, unethical conduct, or invalid conclusions, thereby preserving the integrity of the scientific record (Retraction Watch, n.d.; Martini, 2016). Although retractions remain relatively rare compared with the volume of scientific output, their frequency has increased markedly across disciplines over recent decades, reflecting heightened scrutiny, improved detection mechanisms, and growing awareness of research integrity issues within the academic community (Grieneisen and Zhang, 2012). In the field of Orthopaedics, systematic reviews have demonstrated a rising incidence of retracted publications, with misconduct such as fraudulent data, plagiarism, and duplicate publication emerging as common underlying causes (Yan et al., 2016). Retracted orthopaedic studies have been noted across diverse journals and countries, underscoring the global scope of the challenge and the necessity for robust ethical standards and training for researchers (Ortega and Delgado-Quirós, 2024; Bar-Ilan and Halevi, 2017). Beyond clinical relevance, retractions can have far-reaching implications, including misleading subsequent research, wasting resources, and eroding public trust in science if flawed findings remain uncorrected in the literature. Addressing these concerns requires a comprehensive understanding of the patterns, causes, and consequences of retracted publications in Orthopaedics and allied domains.

REVIEW OF LITERATURE

Previous studies have demonstrated the growing significance of retractions as indicators of research integrity challenges across disciplines and countries. A landmark analysis by Fang et al. (2012) showed that most biomedical retractions were attributable to misconduct rather than honest error, highlighting fraud, duplication, and plagiarism as major causes. Subsequent investigations have reported increasing retraction rates across diverse contexts, including India, Kazakhstan, and business research, with fake peer review, data fabrication, plagiarism, and image manipulation emerging as common reasons for withdrawal (Amit et al., 2023; Kocyigit et al., 2023; Sharma, 2024; Basumatary et al., 2025; Gundur et al., 2025). Recent evidence has also demonstrated that retracted publications often continue to attract citations after withdrawal, thereby extending their influence on scholarly communication and knowledge dissemination (Devanath et al., 2026). Collectively, these studies indicate that retractions are becoming increasingly visible within the scholarly record and reflect broader concerns relating to publication ethics, peer-review integrity, and research governance. However, despite the growing body of literature on retractions, discipline-specific evidence concerning Orthopaedics remains limited. The present study addresses this gap by examining the temporal, institutional, disciplinary, and geographical characteristics of retracted orthopaedic publications using data from the Retraction Watch database.

Objectives of the Study

• To analyse the temporal distribution of retracted publications in Orthopaedics from 1986-2025 in order to identify longitudinal trends in retraction activity.
• To examine the nature and timing of retraction actions, including retraction delays and categories such as corrections and expressions of concern.
• To identify the leading journals and publishers associated with retracted Orthopaedics literature and assess their relative contribution.
• To investigate the distribution of retracted records across document types and their co-associated subject domains to understand disciplinary intersections.
• To identify the major authors and affiliations associated with retracted Orthopaedics.
• To map the geographical participation of countries involved in retracted Orthopaedics publications to reveal global collaboration patterns.

METHODOLOGY

This study employed a quantitative bibliometric approach to examine retracted publications in Orthopaedics using data obtained from the Retraction Watch dataset available through the (https://gitlab.com/crossref/retraction-watch-data) Crossref GitLab repository. Orthopaedics-related records published between 1986 and 2025 were identified using subject-based filtering. Duplicate and irrelevant records were removed, and data were cleaned and standardised in Microsoft Excel to ensure consistency in journal titles, publishers, document types, author names, affiliations, and countries. Retraction delay was calculated as the interval between publication and retraction dates. The final dataset comprised 1,536 records and was analysed using descriptive bibliometric indicators, including frequencies and percentages, to evaluate temporal trends, retraction characteristics, leading journals and publishers, document types, subject associations, major authors and institutions, and geographical distribution patterns.

Ethical Considerations

The study utilised only publicly available secondary data from the Retraction Watch Database and did not involve human participants, personal data, or confidential information. All data were analysed in aggregate form for scholarly purposes, ensuring that no individual authors or institutions were singled out. Proper acknowledgement of the data source was maintained, and the analysis was conducted with the sole intent of understanding retraction patterns to support research integrity and transparency in scientific communication.

RESULTS

Year-wise distribution of publications

Figure 2 exhibits the annual distribution of 1,536 retracted orthopaedic publications from 1986 to 2025, revealing a marked rise in retraction activity over time. Retractions were rare during 1986-2006, accounting for only 21 publications (1.37%), likely reflecting limited mechanisms for detecting research irregularities. A gradual increase was observed between 2007 and 2014 (146 retractions; 9.51%), followed by a substantial rise during 2015-2020 (466 retractions; 30.34%). The most notable surge occurred in 2023, when 471 publications (30.66%) were retracted, exceeding the cumulative total recorded during the first three decades. This increase is likely attributable to enhanced post-publication scrutiny, publisher investigations, and stronger research integrity measures. Although retractions declined in 2024 and 2025, they remained considerably higher than earlier levels. Overall, the concentration of 58.98% of all retractions during 2021-2025 highlights the growing role of scientific self-correction in orthopaedic research.

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Retraction Delays in Publication Patterns

Figure 3 depicts the distribution of retraction delays among 1,536 orthopaedic publications, highlighting that most retractions occur relatively soon after publication. Nearly 60% of papers (916; 59.64%) were retracted within the first two years, while over two-thirds (69.60%) were withdrawn within three years and 78.65% within five years. Thereafter, the frequency of retractions declined markedly, with only 10.67% occurring between 5 and 10 years and 9.18% after a decade. Retractions beyond 15 years were uncommon (3.97%), and only three papers (0.20%) were retracted after 23 years or more. This strongly right-skewed pattern suggests that problematic publications are increasingly identified during the early post-publication period, reflecting enhanced editorial oversight, advances in detection technologies, and greater vigilance towards research integrity within the orthopaedic research community.

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Retraction Nature

Table 1 presents the nature of corrective actions taken on 1,536 orthopaedic publications. Retractions constitute the vast majority of cases (1,435; 93.42%), indicating that complete withdrawal remains the primary mechanism for addressing serious concerns in the published literature. Expressions of concern (69; 4.49%) and corrections (27; 1.76%) were comparatively infrequent, while reinstatements were rare (5; 0.33%). This pattern suggests that journals tend to favour definitive corrective action when substantial issues affecting the validity, reliability, or integrity of research are identified.

Top Journals

Table 2 highlights the journals with the highest numbers of retracted orthopaedic publications. The Journal of Healthcare Engineering (94; 6.12%), Computational and Mathematical Methods in Medicine (87; 5.66%), and BioMed Research International (71; 4.62%) recorded the largest shares of retractions. The prominence of multidisciplinary and computationally oriented journals suggests that retraction activity has been particularly concentrated in publication outlets subjected to extensive publisher-led investigations and research integrity reviews in recent years. In contrast, core orthopaedic journals contributed comparatively fewer retractions. However, the distribution of 855 retractions (55.66%) across 436 other journals indicates that retractions are not restricted to a small number of outlets but represent a widespread issue across the orthopaedic publishing landscape.

Top Publishers

Table 3 presents the distribution of retracted orthopaedic publications across publishers. Hindawi accounted for the largest share of retractions (436; 28.39%), followed by Wiley (215; 14.00%), Elsevier (156; 10.16%), and Springer (102; 6.64%). While retractions were recorded across a wide range of publishers, a substantial proportion was concentrated among a few major publishing groups. This pattern is likely influenced by both their extensive publication output and recent large-scale research integrity investigations that have led to the identification of problematic articles. Nevertheless, the presence of 264 retractions (17.19%) across 121 other publishers indicates that concerns relating to publication quality and research integrity extend across the broader orthopaedic publishing ecosystem rather than being confined to specific publishers.

Document Types

Table 4 indicates that retractions in orthopaedics are predominantly associated with research articles (888; 57.81%), followed by clinical studies (238; 15.49%), highlighting the greater exposure of original investigations to scrutiny and potential research integrity concerns. Meta-analyses (111; 7.23%) and review articles (92; 5.99%) also represent notable proportions, suggesting that issues extend beyond primary research to evidence synthesis, where inaccuracies may have wider implications for clinical decision-making. In contrast, case reports, conference papers, and other document types contributed relatively few retractions. Overall, the findings demonstrate that retractions are concentrated within the core evidence-generating literature that underpins orthopaedic research and practice.

Quarterly Patterns

Table 5 presents the quarterly distribution of 1,536 retracted orthopaedic publications, revealing a relatively balanced pattern throughout the year. Although Qtr3 recorded the highest number of retractions (409; 26.63%), the differences across quarters were modest, with Qtr1, Qtr4, and Qtr2 contributing comparable shares. The absence of pronounced seasonal variation suggests that retraction decisions are driven primarily by the completion of editorial investigations and research integrity assessments rather than by cyclical publishing patterns, resulting in a consistent rate of corrective actions across the year.

Co-associated Subjects

Table 6 illustrates the multidisciplinary nature of retracted orthopaedic publications through 3,367 subject co-assignments. While Medicine-Surgery (411; 12.21%) and Rehabilitation/Therapy (314; 9.33%) represent the core clinical domains, substantial associations with Cellular Biology, Genetics, Biochemistry, Pharmacology, Neurology, and Radiology highlight the increasing integration of orthopaedics with basic, translational, and diagnostic sciences. The presence of retractions across a broad range of subjects, including technology-related fields and 57 additional disciplines (706; 20.97%), suggests that research integrity challenges are not confined to traditional orthopaedic practice but extend across the wider interdisciplinary networks that support contemporary musculoskeletal.

Top Countries

Table 7 presents the country-wise distribution of 1,762 author affiliations associated with retracted orthopaedic publications, revealing a marked geographical concentration. China accounted for the largest share (791; 44.89%), followed by Japan (176; 9.99%) and the United States (154; 8.74%), while India and the United Kingdom also contributed notable proportions. Although retractions were identified across a broad range of countries, their concentration in major research-producing nations likely reflects both higher publication output and greater exposure to post-publication scrutiny. The distribution of affiliations across 49 additional countries further indicates that research integrity challenges in orthopaedics are a global concern rather than being restricted to specific regions.

Top Authors in Retracted Orthopaedic Publications

Table 8 highlights a notable concentration of retracted Orthopaedic publications among a small group of researchers. Yoshihiro Sato (TP-88) and Jun Iwamoto (TP-75) accounted for the highest numbers of retractions, followed by Jose Luis Calvo-Guirado (TP-25), Hideo Matsumoto (TP-24), and Hironobu Ueshima (TP-23). Several other authors from Japan, the United States, South Korea, Italy, and Spain also featured prominently among the top contributors. The predominance of authors affiliated with Japanese institutions suggests a degree of regional clustering; however, these findings should be interpreted cautiously, as high retraction counts may reflect both publication volume and the outcomes of investigations into specific research programmes or collaborative networks. Overall, the concentration of retractions among a limited number of researchers indicates that individual cases can substantially influence the retraction landscape within orthopaedic research.

Top Affiliations in Retracted Orthopaedics Publications

Table 9 identifies the leading institutional affiliations associated with retracted orthopaedic publications. Keio University School of Medicine (TP-71) and Mitate Hospital (TP-57), both in Japan, recorded the highest numbers of retractions, followed by the University of Murcia (Spain) (TP-23), McMaster University (Canada) (TP-21), and Showa University Hospital (Japan) (TP-21). The prominence of several Japanese institutions mirrors the author-level findings and suggests that specific research groups or institutional networks have had a disproportionate influence on the retraction landscape. However, the presence of institutions from Europe, North America, and Asia also demonstrates that retractions are a global phenomenon, reflecting broader challenges related to research integrity and publication quality across the international orthopaedic research community.

DISCUSSION

The findings reveal a substantial transformation in the retraction landscape of orthopaedic research, characterised by a marked concentration of retractions in recent years. Although only 21 retractions (1.37%) were recorded between 1986 and 2006, the period 2021-2025 accounted for 906 cases (58.98%), including a notable peak of 471 retractions (30.66%) in 2023 alone. This sharp increase is more likely attributable to strengthened editorial oversight, publisher-led investigations, advances in plagiarism and image-integrity detection technologies, and growing emphasis on research integrity than to a sudden increase in research misconduct alone. Retraction delay patterns further support this interpretation, with 59.64% of articles retracted within two years of publication and 78.65% within five years, indicating increasingly efficient identification and correction of problematic research. The predominance of full retractions (93.42%) over corrections and expressions of concern also suggests a preference for decisive corrective action when the reliability of published findings is compromised.

The concentration of retractions among a limited number of publishers, authors, and institutions highlights the influence of large-scale investigations and recurring concerns within particular research networks. Hindawi (28.39%), Wiley (14.00%), and Elsevier (10.16%) accounted for a substantial proportion of retractions; however, more than half of all cases were distributed across 436 journals, demonstrating that research integrity challenges are not confined to a small number of publication outlets. Similarly, China accounted for 44.89% of author affiliations linked to retracted publications, followed by Japan (9.99%) and the United States (8.74%), suggesting that retraction patterns may be influenced by publication volume, research expansion, and increased scrutiny within highly productive scientific systems. The multidisciplinary distribution of retracted publications across surgery, rehabilitation, genetics, cellular biology, pharmacology, and related fields further illustrates that integrity concerns extend across both clinical and translational dimensions of orthopaedic research.

Particularly noteworthy is the finding that research articles (57.81%) and clinical studies (15.49%) constituted the majority of retracted publications, while meta-analyses (7.23%) and review articles (5.99%) also accounted for a meaningful proportion. Given the influential role of these study types in evidence synthesis and clinical decision-making, the consequences of retractions may extend beyond the scholarly record and affect healthcare practice. Collectively, the findings suggest that the recent growth in retractions reflects increasing transparency, accountability, and effectiveness of scientific self-correction mechanisms, while simultaneously highlighting the need for continued strengthening of research governance, ethical oversight, and quality assurance within orthopaedic research.

CONCLUSION

This bibliometric assessment provides evidence that the retraction landscape in orthopaedic research has undergone a significant transformation over the past decade. The concentration of retractions in recent years, coupled with shorter retraction delays, suggests that the scholarly community has become increasingly effective in identifying and correcting problematic publications. Rather than viewing retractions solely as indicators of research failure, they may also be interpreted as manifestations of a more transparent and accountable scientific system.

The findings further reveal that retractions are dispersed across diverse journals, publishers, countries, institutions, and subject areas, highlighting the complex and multidisciplinary nature of research integrity challenges within orthopaedics. The occurrence of retractions among clinical studies, research articles, meta-analyses, and review papers is particularly noteworthy because of their potential influence on evidence synthesis and clinical practice. As orthopaedic research continues to expand globally, sustained attention to ethical conduct, methodological rigour, editorial quality control, and post-publication review will be essential to ensure the reliability of the scientific record and maintain confidence in the evidence underpinning patient care.