Twitter Use Among Orthopedic Surgery Journals Correlates With Increased Citation Rates

Use of alternative online means of distribution for research is a rapidly evolving area in orthopedics. In this study, we investigate the impact of Twitter on research citation rates and the association between Altmetric Attention Score (AAS) and citation rates across major orthopedic journals. Original research articles published in a selection of 10 journals between January 2018 and December 2018 were analyzed for number and source of tweets, AAS, and number of citations. We determined the relationship between Twitter use of different sources and number of citations across all journals and within each individual journal, any statistical differences in citations and AAS for tweeted vs nontweeted articles, and the correlation between journal impact factor and average number of monthly tweets. We included 2916 articles in our study, at an average of 26 months after publi- cation. The mean AAS was 9.7 (SD, 45.1; range, 0-1125), and mean citation rate was 6.4 (SD, 8.5; range, 0-166). Impact factor was strongly correlated with average monthly tweets (r2=0.77). Tweeted articles received 8.51 ci- tations on average, compared with 2.56 citations for nontweeted articles (P<.05). Tweets sent by the author/department had the highest impact on future citations (P<.01). Tweets by news outlets had a smaller, positive ef- fect on citations (P<.01). Tweets sent by Arthroscopy (P<.01) and Journal of Pediatric Orthopaedics (P<.01) had high impacts compared with other journals. [Orthopedics. 2023;46(1):e38-e44.]