April 2003 Bulletin

Annual Report of the Journal of the American Academy of Orthopaedic Surgeons

The past 10 years have seen the rapid growth and acceptance of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS) as a well-respected source of information on the diagnosis and treatment of musculoskeletal conditions. Now marking the end of its first decade, JAAOS has seen its circulation grow from 17,604 in 1993 to 29,500 in 2002. In 1993 it was available in a print version only and now it can be read in any of three versions: print, online and CD-ROM, with a fourth, PDA, coming in 2003.

Evolution of editorial content

The number of articles per issue increased to eight during 2002 as the new series "Advances in Therapeutics and Diagnostics" (ATD) debuted in the January/February issue with an article on fluoroquinolones. Subsequent articles focused on COX-2 inhibitors, gabapentin and LMWH. All articles concentrated on uses and complications specifically involving musculoskeletal conditions. In the coming year, an ATD will appear in each issue.

This is the second regular series, joining "Perspectives on Modern Orthopaedics," (PMO) which was initiated in the July/August issue in 1998. The series was developed in conjunction with the Orthopaedic Research Society and continues on an intermittent basis, giving the readership a glimpse at how basic scientific discoveries today may influence treatment modalities in the future.

Because the Internet, computers and PDAs are becoming a larger part not only of the mechanics of running orthopaedic practices but also of the way surgeons seek information and are educated, the editorial board felt it was necessary to address these media as purveyors of information. With the January/ February issue in 2003, they initiated a new section entitled "Web and Wireless Review." Using a book review format, a committee of three experts review Web sites, programs, online textbooks, applications for the PDA, and other Web and wireless products relevant to the practicing orthopaedic surgeon. When this feature is accessed via the online version of JAAOS, there will be direct links to the sites described.

The number of authors submitting unsolicited quality articles to JAAOS has risen; thus, by necessity, the number of solicited articles has diminished dramatically. The associate editors nevertheless continue to solicit authors for contributions for the ATD and PMO series on a fixed schedule. This continues to be a very important process in maintaining the distribution and balance of subjects of JAAOS articles.

Educational activities

To encourage members to share their expertise and improve manuscript quality on initial submission, the Journal presented its first Instructional Course Lecture (ICL) at the AAOS Annual Meeting in 2000, which was designed to help authors write an effective review article. The course, "Writing, Revising and Publishing an Effective Review Article," has been offered for the past three years and will be resubmitted for the 2004 meeting in an interactive format.

Another popular offering has been an ICL on reviewing for orthopaedic journals. "The Art and Science of Reviewing for Orthopaedic Journals" was first presented by Drs. James Heckman and Robert Hensinger at the 2002 meeting. A multi-day workshop on medical writing is also in the planning stages.

Electronic Editions of JAAOS

JAAOS on CD-ROM (1993—2002) has again been produced with the help of a grant from Aventis Pharmaceuticals and was distributed with the March/April edition of JAAOS to all AAOS fellows, candidate members, emeritus members, and international affiliate members. It will be available for sale to others.

Included on both JAAOS on CD-ROM and JAAOS Online are hyperlinks for cited references in each article to their abstracts on MEDLINE. This feature makes both electronic editions of JAAOS very powerful and convenient educational and research tools. Coming are links to other musculoskeletal journals.

In response to a reader survey, complete subject and author indexes for the first nine volumes were added.

JAAOS online

A total redesign of the JAAOS Web site was completed in early 2002. The intent was to make the site more user friendly and to add more features. The new format improved usability, but consideration of additional modifications is underway to further enhance the utility of the site.

Demand for JAAOS content continues to increase dramatically, as indicated by the number of downloaded documents. The average number of visits per days rose from about 250 in January 2001 to almost 1,000 per day in October 2002. The Spanish and Portuguese language abstracts are the most frequently accessed of those available in seven foreign languages.

The number of articles downloaded per month has tripled in the last 18 months, to approximately 15,000 per month.

Other publications

In response to the demand for article reprints, JAAOS has produced three books in the reprint series over the last three years. They include Selected Readings in Trauma (27 articles, 257 pages, 363 copies sold and/or distributed); Selected Readings in Physical Therapy (25 articles, 230 pages, 545 copies sold and/or distributed); Selected Readings in Nonoperative Musculoskeletal Care (228 copies sold and/or distributed).

A collaborative project with the Journal of Bone and Joint Surgery (JBJS) titled JBJS and JAAOS Focus on the Rotator Cuff, composed of 26 articles, was the most recent and most popular with 991 copies sold and/or distributed. Due to the success of this project, additional collaborative reprint books with either JBJS or a specialty journal are being considered.


In December 2002, PERQ Research, Inc. reported that JAAOS is still the most widely and intensively read domestic orthopaedic journal. The percentage of the universe of survey respondents who read four out of four of the last issues of JAAOS is larger than for any domestic journal in the field, and the percentage of contents read is highest among orthopaedic surgeons in all settings. Among hospital-based orthopaedic surgeons, JAAOS is read cover-to-cover by almost 50 percent more readers than any other orthopaedic journal.

Seventy-six percent of respondents said that the frequency should remain at six issues per year; 24 percent felt it should be increased to either nine or 12 times per year. The majority of readers (76.1 percent) found the new feature "Advances in Therapeutics and Diagnostics" to be a useful addition. Respondents were asked about the usefulness of conferring CME credit and those who were interested had increased to 45 percent, while 30.6 percent felt that it was not of interest.

The data does not give a clear indication of the need for conferring CME credit, but that function will be evaluated as it may fit in well with the mandate for "lifetime learning." It seems apparent that the number of issues per year should remain the same for the near future.

JAAOS subscriptions

The total number of JAAOS readers continues to grow steadily and reached a high of 29,500 this year. That number is composed primarily of AAOS Fellows and international members, residents and postgraduate fellows. There are also 2,000 paid subscribers. Due to the loss of a grant supporting subscriptions for residents and postgraduate fellows, there will likely be a drop in readership in the future.

By the end of 2002, JAAOS expanded its reach to an international audience. A Spanish translation was initiated at the beginning of 2002 that very closely reproduces the English version. It has already garnered 670 new subscriptions. A limited Italian summary translation and a Chinese translation may soon begin.

Future directions

The enhanced usage of the online version of JAAOS is an important development, and additional efforts will be directed to that application. In addition, the Journal’s collaborative efforts with JBJS and initiatives with the consortium of orthopaedic journal editors and publishers should bring increased recognition to JAAOS and all of the Academy publications. Having a central access orthopaedic portal on the Web would make acquisition of information on musculoskeletal topics considerably more efficient.

JAAOS will continue to invest in its reviewers by providing feedback in a variety of ways. A major effort this year will be to critically evaluate the review and acceptance process to find ways to shorten the process and be more responsive to authors.

Finally, Journal editors continue to look ahead to anticipate ways in which the delivery of information to readers can be enhanced. They look forward to the next decade with continued growth and prominence of the Journal of the American Academy of Orthopaedic Surgeons by keeping it responsive to its readership.

This article is excerpted from the report given to the Board of Directors in February by Alan M. Levine, MD, Editor-in-Chief of the Journal of the American Academy of Orthopaedic Surgeons.

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