Osteonecrosis Research in Orthopedics and Traumatology: A Global Bibliometric Analysis of Publication Trends, Key Contributors, and Thematic Evolution

OBJECTIVE: Osteonecrosis is a multifactorial pathology of importance in the field of orthopedics and traumatology. The volume of publication and thematic evolution has not been previously analyzed. This study aimed to characterize the scientific production related to osteonecrosis in orthopedics and traumatology, identify the most influential authors, the journals with the highest impact, and the emerging trends in research. METHODS: A bibliometric analysis was performed using the Web of Science Core Collection database. The bibliographic search was performed within the category "Orthopedics," limiting to original articles up to the year 2024. Reviews and other types of non-original publications were excluded. The analysis was performed with the statistical package Bibliometric (R) and VOSviewer 1.6.17, by manual data cleaning and analysis of co-authorship networks, affiliations and co-occurrence of keywords. RESULTS: 1620 articles distributed in 78 journals were identified. The year with the highest number of publications was 2024 (131 articles), with an annual growth rate of 29.25%. Michael A. Mont was the most productive author (34 articles) and Stuart Goodman the most cited (23,139 citations). China was the country with the highest number of publications (375), while the United States led in number of citations (9578 total; 26.98 per article). The most productive journals were Journal of Orthopaedic Surgery and Research (414) and International Orthopaedics (365); however, Journal of Arthroplasty (1733) had the highest citation impact. The most frequent keywords were "osteonecrosis," "core decompression," and "mesenchymal stem cell." The most cited article was "Risk factors associated with deep surgical site infections after primary total knee arthroplasty: an analysis of 56,216 knees" with 451 citations. CONCLUSION: Research on osteonecrosis in orthopedics and traumatology has shown sustained growth, with an emerging focus on advanced surgical interventions and regenerative strategies. The United States and China stand out as leaders in volume and impact, respectively. This bibliometric analysis offers key tools to guide future research, strengthen international collaboration, and improve therapeutic strategies in this pathology.