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Traditional and alternative metrics in the 100 most-cited articles utilizing PearlDiver: Mapping clinical and scientific influence through bibliometric analysis
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DOI：10.1016/j.jor.2025.12.010.png)
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Abstract
En 中文
Background PearlDiver (PD) is a widely used claims database, especially in orthopaedics, yet its academic footprint remains ill-defined. This study aimed to identify the 100 most-cited PD publications, and evaluate the topics described, sub-stratify the most viral articles, and compare the change over time of several article performance metrics. We hypothesized that the most cited articles would (1) address epidemiological questions, and (2) focus on arthroplasty, spine, and sports medicine. Methods Cross-sectional bibliometric study of the 100 most-cited PD articles identified in Web of Science. Records were ranked by total citations and screened in Covidence. Inclusion required full-text confirmation that PD was used as a data source. Extracted variables included total citations, citations per year (CPY) or citation density, Altmetric Attention Score (AAS), and number of X (formerly Twitter) posts. Keyword co-occurrence networks were generated, and correlations among metrics were assessed using Pearson coefficients. Results The top 100 accumulated 6756 total citations (median 54, IQR 38-92). Sports (n = 39), spine (n = 29), and arthroplasty (n = 20) dominated subspecialty representation. The leading studies included Buckland et al. (Bone Joint J, 2017; 227 citations), Montgomery et al. (Arthroscopy, 2013; 303 citations), and Abrams et al. (Am J Sports Med, 2013; 297 citations). Citation density was highest among recent sports and hip arthroscopy studies (Zusmanovich et al., Arthroscopy, 2022; 26.2 citations/year). Arthroplasty papers showed greater AAS and online visibility (mean AAS 41.8 vs sports 16.2; p = 0.041). CPY correlated strongly with total citations (r = .813, p < 0.01), and moderately with X posts (r = .430, p < 0.01), with weaker correlation with AAS (r = .368, p < 0.01). Keyword networks revealed clustering around utilization, complications, and revision themes. Conclusion PearlDiver research is concentrated in sports medicine, spine, and arthroplasty. While PD studies are cost-efficient and highly visible, they remain constrained by reliance on billing codes and limited clinical granularity. The database is most impactful for hypothesis generation, policy guidance, and national utilization analyses rather than directly in clinical practice and decision making.
Keywords:
REGISTRY RESEARCH
HIP ARTHROSCOPY
UNITED-STATES
TRENDS
DATABASES
DEMOGRAPHICS
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