J Knee Surg
DOI: 10.1055/a-2062-0365
Original Article

Social Media Influence and Gender Are Correlated with Industry Payments to Orthopaedic Sports Surgeons

1   VA Medical Center, VA Maryland Healthcare System, Baltimore, Maryland
2   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
2   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
Jie Jiang
2   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
Nathan O'Hara
2   Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland
› Author Affiliations
Funding This work was supported in part by the Career Development Award IK2 BX004879 from the United States (U.S.) Department of Veterans Affairs Biomedical Laboratory Research and Development Service. The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.


Social media, specifically Twitter, has become an increasingly used tool in academic orthopaedic surgery to help surgeons connect with patients and peers. This study seeks to understand correlations among social medial influence, academic influence, and gender among academic orthopaedic sport surgeons. A list of all orthopaedic sports surgeons serving as faculty of sports fellowships in the United States was compiled, along with publicly available demographic information. Their Hirsh indices (h-indices) were obtained using the Scopus database. The Physician Payments Sunshine Act Web site was used to determine their industry payments from 2014 through 2020. The number of Twitter followers was used as a measure of social media influence. Multivariable linear regression models were employed to explore the associations between these parameters and industry payments. Of the 633 surgeons, 33% had a Twitter account. Surgeons with > 1,000 followers (7.3%) were awarded 186% more in nonresearch funding (p = 0.01) and had a higher probability of receiving industry research funding compared with those with no followers (p = 0.03). Sports surgeons had an average h-index of 16, with 44% having ≤ 20 publications and 21% having ≥ 100 publications. Surgeons with ≥ 100 publications were awarded 453% more in nonresearch funding (p = 0.001) and had a 32% higher probability of receiving industry research funding (p < 0.001) when compared with their colleagues with ≤ 20 publications. Female sports surgeons accounted for only 7.9% of surgeons included in the study, and were awarded 65% less in industry nonresearch funding compared with their male colleagues (p = 0.004) when controlling for other factors. Both number of publications and a high level of Twitter activity (> 1,000 followers) had the strongest associations with the quantity of industry nonresearch funding and the highest probability of industry research funding. Female sports surgeons received significantly less industry nonresearch funding compared with their male colleagues. Future studies further exploring gender disparities in industry funding for orthopaedic surgeons may be warranted.

Level of Evidence Prognostic, Level III.

Ethical Review Committee Statement

This work does not involve any human or animal subjects.

Publication History

Received: 21 July 2022

Accepted: 13 March 2023

Accepted Manuscript online:
24 March 2023

Article published online:
24 April 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

  • References

  • 1 Bekelman JE, Li Y, Gross CP. Scope and impact of financial conflicts of interest in biomedical research: a systematic review. JAMA 2003; 289 (04) 454-465
  • 2 Lexchin J, Bero LA, Djulbegovic B, Clark O. Pharmaceutical industry sponsorship and research outcome and quality: systematic review. BMJ 2003; 326 (7400): 1167-1170
  • 3 Okike K, Kocher MS, Mehlman CT, Bhandari M. Conflict of interest in orthopaedic research. An association between findings and funding in scientific presentations. J Bone Joint Surg Am 2007; 89 (03) 608-613
  • 4 Agrawal S, Brennan N, Budetti P. The Sunshine Act–effects on physicians. N Engl J Med 2013; 368 (22) 2054-2057
  • 5 Khan AZ, Kelley BV, Patel AD, McAllister DR, Leong NL. Academic productivity among fellowship associated adult total joint reconstruction surgeons. Arthroplast Today 2017; 3 (04) 298-302
  • 6 Post AF, Li AY, Dai JB. et al. Academic productivity of spine surgeons at United States Neurological Surgery and Orthopedic Surgery Training Programs. World Neurosurg 2019; 121: e511-e518
  • 7 Casciato DJ, Cravey KS, Barron IM. Scholarly productivity among academic foot and ankle surgeons affiliated with US Podiatric Medicine and Surgery Residency and Fellowship Training Programs. J Foot Ankle Surg 2021; 60 (06) 1222-1226
  • 8 Buerba RA, Sheppard WL, Herndon KE. et al. Academic influence and its relationship to industry payments in orthopaedic surgery. J Bone Joint Surg Am 2018; 100 (09) e59
  • 9 Eloy JA, Kilic S, Yoo NG. et al. Is industry funding associated with greater scholarly impact among academic neurosurgeons?. World Neurosurg 2017; 103: 517-525
  • 10 Ence AK, Cope SR, Holliday EB, Somerson JS. Publication productivity and experience: factors associated with academic rank among orthopaedic surgery faculty in the United States. J Bone Joint Surg Am 2016; 98 (10) e41
  • 11 Varady NH, Chandawarkar AA, Kernkamp WA, Gans I. Who should you be following? The top 100 social media influencers in orthopaedic surgery. World J Orthop 2019; 10 (09) 327-338
  • 12 Becker's Orthopedic & Spine Review Names 50 of the Best Spine Specialists in America; 2021. Accessed March 30, 2023, at: Beckershospitalreview.com
  • 13 Logghe HJ, Selby LV, Boeck MA, Stamp NL, Chuen J, Jones C. The academic tweet: Twitter as a tool to advance academic surgery. J Surg Res 2018; 226: viii-xii
  • 14 Seabury SA, Chandra A, Jena AB. Trends in the earnings of male and female health care professionals in the United States, 1987 to 2010. JAMA Intern Med 2013; 173 (18) 1748-1750
  • 15 Beebe KS, Krell ES, Rynecki ND, Ippolito JA. The effect of sex on orthopaedic surgeon income. J Bone Joint Surg Am 2019; 101 (17) e87
  • 16 Forrester LA, Seo LJ, Gonzalez LJ, Zhao C, Friedlander S, Chu A. Men receive three times more industry payments than women academic orthopaedic surgeons, even after controlling for confounding variables. Clin Orthop Relat Res 2020; 478 (07) 1593-1599
  • 17 Velez D, Mehta A, Rotker K, Thavaseelan S. Gender disparities in industry payments to urologists. Urology 2021; 150: 59-64
  • 18 Moore MG, Singerman KW, Kitzmiller WJ, Gobble RM. Gender disparity in 2013-2018 industry payments to plastic surgeons. Aesthet Surg J 2021; 41 (11) 1316-1320
  • 19 Deipolyi AR, Becker AS, Covey AM. et al. Gender disparity in industry relationships with academic interventional radiology physicians. AJR Am J Roentgenol 2020; 215 (02) 494-501
  • 20 Yeh JS, Franklin JM, Avorn J, Landon J, Kesselheim AS. Association of industry payments to physicians with the prescribing of brand-name statins in Massachusetts. JAMA Intern Med 2016; 176 (06) 763-768
  • 21 Nguyen TD, Bradford WD, Simon KI. Pharmaceutical payments to physicians may increase prescribing for opioids. Addiction 2019; 114 (06) 1051-1059
  • 22 AAOS Department of Research. . Quality and SA: Orthopaedic practice in the US; 2018
  • 23 Logghe H, Jones C, McCoubrey A, Fitzgerald E. #ILookLikeASurgeon: embracing diversity to improve patient outcomes. BMJ 2017; 359: j4653