The Top 100 Most Impactful Articles on the Achilles Tendon: An Altmetric Analysis of Online Media
Authors: Gould Heath P. , Bano Joseph M. , Rate William , Civilette Matthew , Cohen Andrew S. , Samuelson Eric R. , Haislup Brett , Bodendorfer Blake M. 
Published: January 2022

Category: Ankle; Hindfoot; Sports Introduction/Purpose: Achilles tendon injuries affect a wide range of individuals, including both recreational and competitive athletes. In the elite athlete population, Achilles tendon ruptures are typically season-ending injuries and can be career-threatening. Due to these impacts on individual players' careers as well as team success, Achilles tendon injuries often generate substantial discussion in the mainstream media and among the general public. However, traditional citation-based metrics fail to capture the dissemination of Achilles research that occurs outside the realm of scientific journal publications. Thus, the purpose of this study was to use the Altmetric Attention Score (AAS) to identify the 100 most impactful articles in online media pertaining to the Achilles tendon and assess their characteristics. Methods: The Altmetric database (Digital Science, Holtzbrinck Publishing) was queried to identify all published articles pertaining to the Achilles Tendon. The articles were stratified by highest to lowest AAS and the top 100 articles with the highest scores were included for analysis. Several data elements were extracted for each article: title, article type, article topic, year of publication, journal name, authors, institutional affiliations, and online mentions (i.e., the number of times the article was mentioned in news, blog, Twitter, Facebook and Wikipedia sources). The geographic origin of each article was also determined by the institutional affiliation of the first author, which was categorized as American (originating in the United States), European (originating in Europe), or Other. Linear regression was used to determine the relationship between online mentions and AAS. Results: The initial search yielded 3,810 articles published between 1957 and 2021. AAS of the top 100 articles ranged from 37 to 476 with a median of 65 (interquartile range: 42-110). The selected articles were published in 39 journals. The most prevalent article type was randomized controlled trial (21.8%), followed by systematic review / meta-analysis (13.9%). The most prevalent article topics were treatment (39.6%), rehabilitation and return to play (11.9%), epidemiology (11.9%), and biomechanics (11.9%). Of the top 100 articles, 25.0% were American, 45.0% were European, and 30.0% were published outside of the United States or Europe. AAS had a strong correlation to Twitter mentions (r = 0.81), a moderate correlation to Google Scholar mentions (r = 0.52), and a weak correlation to Facebook mentions (r = 0.49). Conclusion: This study used AAS to characterize the 100 most impactful Achilles articles in online media. As access to research continues to move away from the conventional printed format, it is critically important to understand how orthopaedic information is disseminated online. Our findings suggest that alternative metrics broaden the definition of article impact beyond what is provided by traditional citation-based metrics and should be considered as a supplemental means of assessing the overall impact of published scientific literature.