The medial ulnar collateral ligament (MUCL) is a commonly injured ligament in athletes who compete in sports involving overhead throwing. Due to the implications of MUCL injuries on the careers of elite-level throwers (e.g. baseball pitchers), discussion surrounding the MUCL often extends beyond the sphere of physicians and academics to include the general public and mainstream media. Although prior studies have sought to identify the most impactful MUCL articles based on citations, the traditional metrics of article fail to account for the online influence of published articles. The purpose of this study was to identify the 100 most impactful MUCL articles in online media using the Altmetric Attention Score (AAS) and compare their characteristics to the most-cited MUCL articles in the scientific literature.
The PubMed MeSH terms “medial ulnar collateral ligament”, “ulnar collateral ligament”, and “medial collateral ligament” were entered into the Altmetric Explorer search tool. All articles not pertaining to the elbow (e.g. thumb, knee) were excluded. Outputs of this query were stratified by Altmetric Attention Score (AAS) and the top 100 articles were selected. The following characteristics of each included article were extracted: title, year of publication, journal name, article type, article topic, and the number of online mentions (e.g. Google, Facebook, Twitter, news, blogs, policy). 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.
AAS of the top 100 MUCL Articles ranged from 7 to 482 with a median of 20 (25th percentile: 12, 75th percentile: 32.5). The selected articles were published in 22 journals, with 74 of 100 articles attributed to three journals: American Journal of Sports Medicine (AJSM), Journal of Shoulder and Elbow Surgery (JSES), and Orthopaedic Journal of Sports Medicine (OJSM). The most common article type was Retrospective Cohort (20%) while Laboratory Study (13%) was the next most common article type. The most common article topic was Treatment of UCL injury (25%), followed by Epidemiology / Risk Factors (23%) and Rehabilitation / Return to Play following UCL injury (19%). Of the top 100 articles, 94% of the articles originated from within the United States, 2% of the articles originated from Europe, and 4% originated outside of the United States or Europe.
The present study identified the 100 most impactful MUCL articles in online media based upon AAS. The characteristics of these articles differed substantially from the most-cited MUCL articles in the scientific literature in terms of article type, article topic, geographic origin, and journal of publication. These findings indicate that traditional citation-based metrics and alternative metrics are fundamentally different and should be used in concert to obtain the most complete assessment of article impact.