This document introduces the research paper titled “Research hotspots and trends of sarcopenia in orthopaedic surgery: a bibliometric analysis from 2003 to 2023“. Authored by Ruijiang Li, Yufeng Ge, Yixiao Chen, Gang Liu, Feng Gao, Chao Tu, Ting Li, Ling Wang, Minghui Yang, and Xinbao Wu, and published in Frontiers in Surgery on May 6, 2025, this study provides a comprehensive overview of the scientific landscape at the intersection of sarcopenia and orthopaedic surgery over the past two decades.
The primary purpose of this bibliometric analysis was to:
- Evaluate the current bibliometric characteristics, progress, and hotspots of cross-sectional research in orthopaedic surgery and sarcopenia from January 2003 to December 2023.
- Assess global and domestic scientific advancement in this field.
- Identify emerging trends.
- Provide crucial theoretical foundations for future research and clinical protocol development.
To achieve these objectives, the researchers screened publications from the Web of Science Core Collection database between January 2003 and December 2023, specifically focusing on articles and review articles in English. The search strategies utilized broad terms for both “sarcopenia” and “orthopaedic surgery”. Data analysis and visualization were performed using a suite of tools including Microsoft Office Excel, VOSviewer, CiteSpace, and Bibliometrix (R package). These tools allowed for assessments of authors, countries, institutions, keywords, and references, as well as co-occurrence and co-citation analyses.
Key findings from the study include:
- A total of 1,815 documents were identified, authored by 8,592 researchers from 2,376 organizations across 77 countries and published in 285 journals.
- There has been a steady and rapid increase in publications in this field from 2003 to 2023, with a significant surge observed since 2013. The annual publication number consistently exceeded 100 since 2018, peaking at 211 papers in 2022, indicating growing global interest.
- The United States emerged as the leading country in both publication volume (n = 404) and total citations (n = 20,240). Japan, China, South Korea, and Australia also showed significant contributions.
- The University of Melbourne in Australia was the most productive institution, with 76 publications.
- Osteoporosis International was identified as the core journal, having the highest number of publications (n = 125) and citations (n = 2,621) in this area.
- Cawthon PM was highlighted as the most influential author, with 21 publications and 3,271 citations. Duque, Gustavo was the most productive author with 34 publications.
- Keywords were categorized into four clusters, representing key research directions:
- Cluster 1: Epidemiology and pathophysiology of sarcopenia.
- Cluster 2: Clinical outcomes.
- Cluster 3: Management.
- Cluster 4: Physical function.
- Common keywords include “sarcopenia,” “body composition,” “muscle strength,” “hip fracture,” and “mortality”.
- Recent research trends indicate a shift towards “osteosarcopenia,” “consensus guidelines,” “meta-analytical approaches,” “elderly/aging,” “frailty,” “muscle strength (handgrip quantification),” “osteoporosis/bone density metrics,” “fragility fracture epidemiology,” and “survival prediction models”.
- The analysis of citation bursts revealed that earlier research (2003–2017) focused on “injury,” “fixation,” and “BMI,” while since 2017, the focus has shifted towards “consensus,” “treatment strategies,” and “clinical outcomes” related to sarcopenia.
- Sarcopenia is defined as a syndrome characterized by low muscle strength, reduced skeletal muscle mass and quantity, and decreased physical activity capability, with the updated 2019 EWGSOP2 guidelines emphasizing muscle strength. It significantly impacts functional independence, quality of life, and survival rates, and is closely linked to orthopedic diseases like osteoporosis, fracture, and arthroplasty.
In conclusion, this bibliometric analysis reveals a rapidly expanding research field with a clear shift towards understanding clinical outcomes, developing consensus guidelines, and exploring management strategies for sarcopenia in the orthopaedic context. The study emphasizes that exercise and nutritional interventions are currently the most effective treatments, while pharmacological approaches require further investigation. Future research is expected to delve deeper into the molecular mechanisms of muscle-bone crosstalk and the development of multidisciplinary management approaches for elderly sarcopenic patients in orthopaedic settings.
Reference: Li, R., Ge, Y., Chen, Y., Liu, G., Gao, F., Tu, C., Li, T., Wang, L., Yang, M., & Wu, X. (2025). Research hotspots and trends of sarcopenia in orthopaedic surgery: a bibliometric analysis from 2003 to 2023. Frontiers in Surgery, 12, 1564923. https://doi.org/10.3389/fsurg.2025.1564923
