Diversity, Equity and Inclusion in Publications in Orthopaedics: A Ten-year Geographical and Subject Assessment

Introduction Orthopaedic research output varies across the U.S., shaped by institutional priorities and resources. This study examines geographic trends in diversity, equity, and/or inclusion (DEI) topics within orthopaedic publications over the past decade. Methods A search of orthopaedic surgery articles published between January 1st, 2014 to April 30th, 2024 was conducted through PubMed. Articles retrieved underwent a two-reviewer screening process to confirm primary focus of diversity topics within orthopaedics. Included articles were organized by location of the first author’s institutional affiliation and year published. Article focus was then categorized by the following major categories: race/ethnicity, sex, LGBTQ+, and/or socioeconomic status. Results Out of 424 articles which met inclusion criteria, 378 (89.2%) were published by authors affiliated with U.S. institutions. New York (n=41) and California (n=41) had the most orthopaedic publications with a DEI focus, while 13 states had zero associated publications. Sex was the most common subject of focus, followed by race/ethnicity, socioeconomic status, and LGBTQ+. Discussion The results of this review illustrate how there appears to be distinct geographical differences in orthopaedic publications which focused on DEI, with two states publishing a relative majority of manuscripts. Specific subtopics were also more prominent than others, with sex disparities representing the predominant focus. Our review therefore sheds light on the presence of geographic variations in DEI-related research and the potential practical significance of these trends.