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VOL. 78-B, N
O
. 6, NOVEMBER 1996 861
P. Fulford, Editor
L. Lidgren, President EORS
©1996 British Editorial Society of Bone and Joint Surgery
0301-620X/96/67275 $2.00
J Bone Joint Surg [Br] 1996;78-B:861-2.
Research section
For nearly 50 years, the British Volume of the Journal of
Bone and Joint Surgery has accepted and published papers
on the whole range of orthopaedic surgery from all parts
of the world. The expansion and diversification of the
work of what is now the largest group of surgeons have
made it progressively more difficult to review and select
the best of the submitted papers. We had expected that the
introduction of more and more specialist journals within
orthopaedics would reduce this pressure, but this did not
happen. It is apparent that many authors share our view
that important advances deserve wider publicity than that
provided to the small group who read the appropriate
specialist journal.
In 1995 well over 1000 papers were received, ranging
from clinical and practical orthopaedic surgery to the basic
science of the musculoskeletal system. About one-third of
these came from the UK, one-third from 21 of the countries
of continental Europe, and one-tenth from each of the USA
and Japan. The most important trend was their increasingly
complex scientific nature. This is slowly (some would say
much too slowly) changing the emphasis from subjective
reporting of case series to objective and scientific analysis
of planned studies. The change has been speeded up by the
welcome expertise and methodology provided by collab-
oration with scientists such as bioengineers and biochem-
ists, and with statisticians and epidemiologists.
The Journal has always published a number of papers on
basic research but the pressure on space, confirmed by our
84% rejection rate for last year, has meant that some good
scientific papers have had to be rejected. The reason some-
times given was the lack of obvious or early clinical
relevance for the general orthopaedic surgeons who con-
stitute the bulk of our readership, over 92% of them outside
the UK.
We have always wished to increase the number of papers
on basic science, but the difficulties of lack of space, the
need for fair selection and the requirement for expert
editing in diverse scientific fields have seemed to be insur-
mountable. Thanks to very helpful discussions and then
agreement with the European Orthopaedic Research Soci-
ety (EORS) we now have a solution.
From January 1997, the Journal will increase in size and
will contain a regular section on ‘Research in Orthopae-
dics’. This will be edited by a new Deputy Editor for
Research, Mr Neil Rushton MD FRCS, of Cambridge, who
has been appointed jointly by the Journal and the EORS.
He will be responsible for the review and eventual selection
of papers for the research section and for the necessary
editing.
In this he will have the full support of the EORS, through
an editorial board for research with members and reviewers
from a broad field of researchers in musculoskeletal dis-
ease. This co-operative venture between the Journal and the
EORS is intended to improve the standard of papers in
basic science published in the Journal. As for all other
Journal papers, blinded reviewing will help to ensure
unbiased selection. Papers which are submitted directly to
the Journal and those which arrive through the auspices of
the EORS will both undergo the same careful processes of
review, acceptance, revision and editing. To increase the
interest of our general readers we shall ask the authors of
accepted papers to provide an appropriate explanatory
statement for publication with their paper.
We believe that the new section will be a valuable
addition to the peer-reviewed and carefully selected content
of the Journal, and are grateful to the EORS for their
initiative, confidence and support.
PHILIP FULFORD
EDITOR
The European Orthopaedic Research Society (EORS) is a
rapidly growing organisation which was founded in 1989
and now has members from all parts of the world. It meets
annually; every second year at the same time as the EFORT
Congress. At three-year intervals there is a combined meet-
ing with the Canadian, American, and Japanese Ortho-
paedic Research Societies.
The most important goals of the EORS are to enlarge the
scientific basis of orthopaedics by creating networks for
musculoskeletal research in Europe, and to promote the
participation of orthopaedic surgeons in interdisciplinary
research of high quality. To compete successfully with
other disciplines and to gain research funding it is impor-
tant that high-quality peer-reviewed papers are selected and
published in high-impact Journals with a large circulation.
The decision by the EORS to join the London-based
volume of the Journal of Bone and Joint Surgery and not to
start its own research journal is based on the large number
of subscribers to the Journal throughout the world and the
EDITORIALS
THE JOURNAL OF BONE
AND JOINT SURGERY
importance of combining the interests of both orthopaedic
surgeons and preclinical researchers in one publication.
There has been a profound shift during recent decades
from patient-orientated studies to research at the cellular
and molecular level. Clinical research and audit in ortho-
paedics are time-consuming, and the most difficult and the
slowest of all research, partly because of the long follow-up
required. This has led to the increasing interest in basic
research including such subjects as molecular biology and
cytogenetics. These types of research are certainly impor-
tant and necessary in orthopaedics, but need to be related to
clinical problems.
For this reason, more orthopaedic surgeons are required
with interests in research and in identifying clinical prob-
lems; the ‘reductionist’ researchers can then help with the
necessary techniques. This calls for the combined efforts of
orthopaedic surgeons and basic researchers. I see this co-
operation symbolically as a nerve system, which starts from
a clinical question, then sprouts into different branches of
basic research, and eventually gathers the results together
again for the benefit of our patients.
Some walls in Europe have already been torn down and
borders have been opened. I hope that the EORS will be
able to establish increasing co-operation in research net-
works, not only in Europe, but also between continents.
The Journal of Bone and Joint Surgery will unquestionably
provide the means of spreading information on muscu-
loskeletal research throughout the world.
The EORS has selected an Editorial Board from various
fields relevant to all aspects of musculoskeletal disease; its
membership will be announced soon, and all will take an
active part in the review process.
Our society is looking forward to this new co-operative
venture.
LARS LIDGREN
PRESIDENT EORS
Advice for authors - blinding and references
All journals and their editors conduct a balancing act
between the overlapping groups which they try to serve.
Authors would like 100% acceptance; individual subscrib-
ers would like us to publish only good articles that will
interest them personally. In the not-so-distant future, elec-
tronic means such as unlimited Internet memory and com-
puter ‘Knowbots’ trained to make such individual
selections, may be able to satisfy both groups (La Porte et
al BMJ;310:1387-90). But at present one of our main tasks
is the fair and efficient selection of the 16% of submissions
that we are able to publish.
To increase the fairness of the selection process, we
decided to start to blind our reviewers to the source of the
submitted paper (editorial March 1996; 173-4). This has
proved to be a satisfactory innovation and already approx-
imately 70% of manuscripts arrive with a second cover
page on which the names and addresses of the authors and
the source of the work have been omitted. This is not quite
enough; our astute reviewers often find clues in the text and
in the references, on the back of illustrations and even on
the envelopes containing them. In specialist subjects a
reviewer may already be aware of the work, having heard it
presented at a meeting. Blinding can rarely be perfect but it
is designed to protect the author from prejudice and is in
his interest; we hope for more and better blinded submis-
sions, but we shall not return unblinded manuscripts.
The other change also announced in March 1996 and
starting in our January 1997 issue is in our method of
publishing references. We shall use the so-called ‘Vancouv-
er’ system in which references in the text are numbered in
the order of their appearance and the reference list at the
end of the paper is in the order of these numbers. The main
reasons for this change are the space taken up by strings of
names and dates in the text, the increasingly specialist and
scientific nature of published papers, and the wish to
provide the best format for electronic presentation and
publication.
The main objection, concerning which we have
received just one letter, is that it will no longer be so easy
to scan a reference list for a known first author or key
paper. This seems a small price to pay for the improve-
ments which will allow us to publish more papers and
bring us into line with most scientific and general medical
journals.
We will continue to review submitted papers in any
reference format, but in future intend to return accepted
papers for conversion to the correct format before editing
begins. Our “Guide to Authors” has been amended, but it is
well known to editors that this page of their journal is
rarely studied.
PHILIP FULFORD
EDITOR
862 EDITORIALS
THE JOURNAL OF BONE AND JOINT SURGERY
