The publication process in scientific journals typically involves multiple submissions, revisions, and delays. In the field of orthopaedics, limited data exist regarding publication dynamics. To address these gaps, we aimed to answer the following questions: (1) What is the average number of submissions needed for an article before publication? (2) What is the average time from submission to final publication? (3) What factors influence the number of submissions and the time to publication?

We hypothesized that the number of submissions to publication in different journals is relatively low

Nine French academic teams were contacted, of which five agreed to participate in this study. Each participating team provided all the manuscripts they had produced and submitted to any journal between 2015 and 2023. In total, 128 articles were collected. For each article, data were collected regarding the number of submissions to different journals, time from submission in the accepting journal to online publication, number of revision rounds within the final journal, study type, number of authors, level of evidence, journal impact factor (IF) and scope (general orthopaedic versus subspecialised), and post-publication citation count. Correlations between these different outcomes were investigated.

On average, articles were submitted to 1.7 ± 1.2 journals (range, 1–7), with 74/128 (58%) of them being accepted by the first journal. The mean time to publication was 256 ± 221 days (range, 22–1220), with 2.74 ± 1 revision rounds (range, 1–7). Most studies were retrospective (n = 72/128 (56.2%)) and Level 4 evidence (n = 101/128 (78.8%)). The average journal impact factor was 2.78 ± 1.98 (range, 0.5–18.5), and the mean citation count (according to Google Scholar) was 14.319.7 (range, 0–111). No significant correlation was found between time to publication or number of submissions and study type, author count, or level of evidence. However, time to publication was moderately negatively correlated with journal IF (ρ = -0.347, p = 0.0009), indicating that higher IF journals had shorter time to publication. Articles were more likely to be rejected when first submitted to high IF journal (p = 0.013) or a subspecialized journal compared to generalist orthopaedic journals (p = 0.013), but shorter delays were observed with the latter (p = 0.025). Citation count showed no correlation with journal impact factor.

Most orthopaedic research articles were accepted in the first or second journal they were submitted to, although the time to publication remained lengthy. Higher journal impact factor as well as a subspecialized journal scope were the only factors significantly associated with faster publication. Article type, number of authors, and level of evidence had no measurable impact. These findings emphasize the role of editorial dynamics over manuscript characteristics in determining publication timelines.

IV.