Background: The open-access model has changed the landscape of academic publishing over the last 20 years. An unfortunate consequence has been the advent of predatory publishing, which exploits the open-access model for monetary gain by collecting publishing fees from authors under the pretense of being a legitimate publication while providing little-to-no peer review. This study aims to investigate the predatory publishing phenomenon in orthopaedic literature. Methods: We searched Beall’s List of Predatory Journals and Publishers and another list of predatory journals for journal titles that are possibly related to orthopaedics. We then searched their web sites for the following information: total number of articles published, journal country of origin, author country of origin, article processing charge (APC), quoted review time, and location of the listed headquarters. We also reported the article quality of a random sample of these journals. We consulted InCites Journal Citation Reports to determine the number of nonpredatory orthopaedic publications that are indexed, and we manually searched a random sample of these legitimate journals for Beall’s criteria. Additionally, we searched the Directory of Open Access Journals (DOAJ) and PubMed databases for any possible predatory journal titles. Results: We found 104 suspected predatory publishers, representing 225 possible predatory journals. One journal was indexed in the DOAJ, and 20 were indexed in PubMed. Review time was not identified for 56.2% of the journals, and 36.5% quoted a review time of <1 month. Nearly half of the listed addresses of the publishers were either unsearchable or led to residential or empty lots. Eighty-two legitimate journals were identified. The median APC was $420 for predatory journals and $2,900 for legitimate journals. We found that a random sample of the legitimate journals published studies with higher reporting standards, but a few also contained 1 criterion that is found on Beall’s list. Conclusions: This study highlights the scope of orthopaedic predatory publishing. Possibly predatory journals outnumber legitimate orthopaedic journals. Orthopaedic surgeons should be aware of the suspected predatory journals and consult available online tools to identify them because distinguishing them from legitimate journals can be a challenge.

The incidence of stroke in Bahrain is rising in the Bahraini population and has nearly doubled over the last 16 years, while the incidence in the non-Bahraini population has not changed. Incidence of stroke in the Bahraini population (110/100,000) is now much greater than in the non-Bahraini population (27/100,000). The Bahraini stroke population is 10 years younger than Western comparators with a much higher prevalence of many of the risk factors for stroke, including diabetes (54%), hypertension (75%) and hyperlipidemia (34%). The combination of an ageing Bahraini population alongside a high prevalence of risk factors suggests a 'ticking time bomb' that is likely to see a continuing rise in the incidence of stroke. The quality of risk factor prevention and hospital-based stroke care is therefore crucial in Bahrain. While 88% of patients were scanned within 24 h and 86% with non-haemorrhagic strokes were commenced on aspirin within 48 h, none of the patients received thrombolysis or were admitted to a stroke unit. Improvement of stroke outcomes in Bahrain could be achieved through implementation of evidence-based measures, including improved risk factor management in primary care and stroke units and thrombolysis in secondary care.

Context: Snapping scapula syndrome (SSS) is commonly misdiagnosed and underreported due to lack of awareness. Objective: This scoping review aims to summarize the current evidence related to SSS diagnosis and treatment to aid clinicians in managing the condition more effectively. Data Sources: PubMed, Medline, and Embase databases were searched for studies related to the etiology, diagnosis, or treatment of SSS (database inception to March 2020). Study Selection: Databases were searched for available studies related to the etiology, diagnosis, or treatment of SSS. Study Design: A scoping review study design was selected to explore the breadth of knowledge in the literature regarding SSS diagnosis and treatment. Level of Evidence: Level 4. Data Extraction: Primary outcomes abstraction included accuracy of diagnostic tests, functional outcomes, and pain relief associated with various nonoperative and operative treatment options for SSS. Results: A total of 1442 references were screened and 40 met the inclusion criteria. Studies commonly reported SSS as a clinical diagnosis and relied heavily on a focused history and physical examination. The most common signs reported were medial scapular border tenderness, crepitus, and audible snapping. Three-dimensional computed tomography had high interrater reliability of 0.972, with a 100% success rate in identifying symptomatic incongruity of the scapular articular surface. Initial nonoperative treatment was reported as successful in most symptomatic patients, with improved visual analogue scale (VAS) scores (7.7 ± 0.5 pretreatment, to 2.4 ± 0.6). Persistently symptomatic patients underwent surgical intervention most commonly involving bursectomy, superomedial angle resection, or partial scapulectomy. High satisfaction rates of surgery were reported in VAS (6.9 ± 0.7 to 1.9 ± 0.9), American Shoulder and Elbow Surgeons scores (50.3 ± 12.2 to 80.6 ± 14.9), and mean simple shoulder test scores (5.6 ± 1.0 to 10.2 ± 1.1). Conclusion: Focused history and physical examination is the most crucial initial step in the diagnostic process, with supplemental imaging used to assess for structural etiologies when nonoperative management fails. Nonoperative management is as effective as surgical management in pain relief and is advised for 3 to 6 months before operative treatment.

* The purposes of the present scoping review were to identify (1) the available studies regarding the efficacy of cannabinoids for the management of musculoskeletal pain and related conditions and (2) the knowledge gaps and opportunities in this area of research.* There is little high-quality evidence for medical cannabis in the core orthopaedic areas of arthritis, postoperative pain, back pain, and trauma-related pain.* The “best available” evidence suggests cannabis can be effective for managing arthritis pain, back pain, and trauma-related pain, although the quality of the evidence is poor.* Evidence regarding the use of cannabinoids for the management of postoperative pain is mixed.* Research on pain control in patients with arthritis, conditions related to the spine, and traumatic injuries represents major under-represented areas of study for the role of cannabinoids, and high-quality Level-I studies are needed.

With solid tumor cancer survivorship increasing, the number of patients requiring post-treatment surveillance also continues to increase. This highlights the need for evidence-based cancer surveillance guidelines. Ideally, these guidelines would be based on combined high-quality data from randomized controlled trials (RCTs). We present a systematic review of published cancer surveillance RCTs in which we sought to determine the feasibility of data pooling for guideline development. We carried out a systematic search of medical databases for RCTs in which adult patients with solid tumors that had undergone surgical resection with curative intent and had no metastatic disease at presentation, were randomized to different surveillance regimens that assessed effectiveness on overall survival (OS). We extracted study characteristics and primary and secondary outcomes, and assessed risk of bias and validity of evidence with standardized checklist tools. Our search yielded 32,216 articles for review and 18 distinct RCTs were included in the systematic review. The 18 trials resulted in 23 comparisons of surveillance regimens. There was a highlevel of variation between RCTs, including the study populations evaluated, interventions assessed and follow-up periods for the primary outcome. Most studies evaluated colorectal cancer patients (11/18, [61%]). The risk of bias and validity of evidence were variable and inconsistent across studies. This review demonstrated that there is tremendous heterogeneity among RCTs that evaluate effectiveness of different postoperative surveillance regimens in cancer patients, rendering the consolidation of data to inform high-quality cancer surveillance guidelines unfeasible. Future RCTs in the field should focus on consistent methodology and primary outcome definition.