AAOS Bulletin - April, 2005

JAAOS 2004 Annual Report

Positioning for change

By Alan M. Levine, MD

The year 2004 has been one of planning for the future of the Journal of the American Academy of Orthopaedic Surgeons (JAAOS) and positioning it for change. The past 12 years have seen the rapid growth and acceptance of JAAOS as a well-respected source of information on the diagnosis and treatment of musculoskeletal conditions.

A variety of editorial and financial factors precipitated consideration of the future of the publication. As a result of the increasing breadth and depth of information on musculoskeletal conditions, the increasing number of high-quality articles submitted to JAAOS and changes in the advertising market, consideration was given to transitioning the journal from bimonthly to monthly publication. A business plan was created, the editorial process was restructured and the proposal for doubling the number of issues of JAAOS per year was accepted by the AAOS Board of Directors.

Other related changes, such as online submission and review of manuscripts, hiring of a new subscription representative, and collaborative projects with Orthopaedic Knowledge Online (OKO), should all have a positive impact on the future of JAAOS.

Alan M. Levine, MD, outgoing Editor-in-Chief of the Journal of the American Academy of Orthopaedic Surgeons


The associate editors have continued to be a very dedicated group. Associate editors perform an important task as the body that helps make decisions on changes in the journal content, structure and functioning. Their role should not change dramatically with the transition [to a monthly publication], but there have already been slight changes made to have a more intensive review completed prior to forwarding the manuscript to the editor-in-chief.

We have continued to actively track both the timeliness and quality of the reviews. The associate editors objectively grade the quality of each review for an article. Each year we try to add a group of new, younger reviewers in the subspecialty areas. We continue to try to improve the review process by distributing the blinded reviews for an article to reviewers to allow them to see their reviews in context and by making the annual reviewers’ meeting at the Annual Meeting an educational session.

At the Annual Meeting in 2004, we presented an instructional course lecture (ICL) aimed at improving the skills of the reviewers for all journals, titled “The Art and Science of Reviewing for Orthopaedic Journals.” The ICL was well received, and two articles on the topic were in ICL volume 53 (2004).


The number of articles per issue remained at nine during 2004, with about 70 pages of editorial content in each issue. There are three regular series of articles: Web and Wireless Review, Perspectives on Modern Orthopaedics, and Advances in Diagnostics and Therapeutics (ADT). In addition there are six regular review articles in each issue.

As part of our continuing relationship with OKO, we initiated a program to cite video programs in OKO that correlate with article topics in JAAOS. These are noted in the table of contents in JAAOS, and there is a hotlink in electronic versions.

Additionally, a new article type will be published beginning in September 2005 on surgical techniques, again in coordination with OKO. The article will stress the technical description of a surgical technique, along with pearls and pitfalls gleaned from the author’s experience with the technique. It will be accompanied by five or six key illustrations and will, in most cases, have a link to a video presentation on OKO of the same technique. This feature is planned to alternate with the ADT series on a monthly basis.

There has been an ongoing discussion about the application of the meta-analysis technique as a method of reviewing the orthopaedic literature. The editorial board decided that it was relevant in certain selected areas. A meta-analysis of articles describing methods to “clear the cervical spine” in the trauma setting has been initiated. Others will be considered, as appropriate.

Electronic editions

JAAOS on CD-ROM (1993-2004) has again been produced with the help of an educational grant from sanofi~aventis and will be distributed to all AAOS fellows, candidate members, emeritus members and international affiliate members. It will be available for sale to others. Included 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. Complete subject and author indexes for the first 11 volumes were added.

The JAAOS Web site will be redone to meet current levels of online sophistication. Initial work has been done, and the redesign should be implemented by May 2005, which we hope will add increased functionality for the users.

Demand for JAAOS content continues to increase dramatically, as indicated by the number of downloaded documents. The online version will become increasingly important as a way to convey educational material to the international community. The Spanish and Portuguese abstracts are the most frequently used of those available in seven foreign languages. The total number of PDF abstract files (all languages) downloaded per month has gone from about 5,000 in 2001 to just over 20,000 per month in 2004.

Survey results

In December 2004, PERQ Research, Inc. reported that JAAOS is still the most widely read domestic orthopaedic journal, read by 80 percent of office- or hospital-based survey respondents. The Journal of Bone and Joint Surgery ranked second, read by 75 percent of respondents, and Orthopaedics Today was read by 65 percent of respondents.

JAAOS subscriptions

The total number of JAAOS readers averaged 29,000 this year, primarily AAOS members, AAOS international members, residents and postgraduate fellows; it also includes 1,600 paid subscribers.

International distribution in translation has become a very important source of subscriptions, distribution of the editorial content and royalty income for JAAOS. The first translation agreement was made eight years ago with Centro Scientifica Editore. Through this agreement, five or six JAAOS articles are published each quarter in an Italian translation with a print run of 5,000 copies.

A Spanish translation of JAAOS, published by Medicina STM Editores in Barcelona, Spain, was initiated in January 2002. It currently has more than 500 subscribers and looks almost identical to the English version. It is available both in print and online by subscription.

A Turkish version published by ACT Medikal debuted in January/February 2003 and has a print run of 1,300 copies. The Portuguese version began with the July/August 2003 volume and has a print run of 5,000 copies. There is now a Korean version with a print run of about 1,000 copies, of which almost 300 are paid subscriptions. Negotiations are ongoing for distribution and translation of JAAOS in China.

In 2005 AAOS received an unrestricted educational grant from Pfizer, Inc. for the development and production of a CD-ROM on Corticosteroid Injection Techniques that was inserted in the January/February issue of JAAOS.

Collaboration with OKO

A number of initiatives have been undertaken to maximize utilization of AAOS publications. The first program was citing related videos on OKO with appropriate articles in JAAOS.

The next project is the “Surgical Techniques” articles, in which an article describing the surgical technique will be published in conjunction with the presentation, on OKO of a section with a video of the technique. This will allow the reader to both view the video and print out the article with an outline of the technique and drawings of critical steps.

Future directions

The next year should be a very exciting one for JAAOS. It is poised to make a series of transitions that should enhance its reputation and educational value. With the new editor-in-chief, William P. Cooney III, MD, changes should be expected in the editorial board membership. Transition to electronic review should enhance satisfaction for the authors.

The transition to monthly publication, with its increase in the amount of editorial material, solicitation of articles, and ability to maintain diversity of content, should make JAAOS more competitive in the advertising market, giving it increased financial resources for future development. The Web site development holds real potential for increasing the presence and use of the online version of JAAOS. All of these changes will certainly serve the central mission of the AAOS and JAAOS: to provide the highest quality education material for our members and readership.

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

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