Mapping the Scientific Landscape of Arthroscopy Research in Nepal (2010–2025): A Scopus-Indexed Bibliometric Study

Study design

This study is a bibliometric analysis aimed at quantifying arthroscopy-related research output from Nepal, evaluating publication trends, authorship patterns, institutional contributions, and international collaborations over 15 years from 2010 to 2025. The analysis provides insight into the growth and impact of Nepalese arthroscopy research within regional and global contexts.

Data source and search strategy

Data were retrieved from the Scopus database, selected for its comprehensive coverage of peer-reviewed literature and robust bibliometric capabilities. The search was conducted on September 5, 2025, using the query: (TITLE-ABS-KEY [arthroscopy OR arthroscopic] AND AFFILCOUNTRY [nepal]) AND PUBYEAR >1999 AND PUBYEAR <2026, targeting publications with at least one author affiliated with a Nepali institution. The timeframe was chosen to capture contemporary trends in arthroscopy research. Comparisons with regional and international publication trends were restricted to studies retrieved using similar search strategies for the individual country in Scopus databases, ensuring replicability of data.

Inclusion and exclusion criteria

The study included all documents from the Scopus database that met the criteria for search strategy, affiliation, and publication year. Publications without a Nepalese affiliation were excluded to maintain consistency and relevance. Non-indexed journals were noted but excluded from the quantitative analysis, as they are not captured in Scopus, which may result in underrepresentation of the total research output.

Data extraction

From the retrieved publications, detailed bibliometric information was extracted, including year of publication, document type, journal title, author names, institutional affiliations, total citations, h-index, and international collaborations. Special attention was given to standardizing institutional names to account for variations, which could otherwise fragment institutional output and affect analyses of productivity and collaboration networks.

Data analysis

Bibliometric indicators were analyzed using Scopus’s built-in analytical tools, complemented by MS Excel 2013 and VOSviewer (version 1.6.20) for network mapping of co-authorship, institutional collaboration, and country collaborations. Analyses included annual publication trends, citation metrics, top contributing authors and institutions, and collaborative cluster visualization to identify patterns of research concentration and international partnerships. Self-citations were considered for analysis.

Ethical considerations

As the study utilized publicly available bibliometric data, no institutional review board approval or informed consent was required.

Publication trend

A total of 47 documents on arthroscopy/arthroscopic research affiliated with Nepal were indexed in Scopus between 2010 and 2025. No publications were recorded before 2010. The annual output remained low in the first half of the study period, with single publications in 2010 and 2011, and intermittent activity until 2018. A steady rise was observed from 2019 onwards, peaking in 2021 (n = 8) and 2024 (n = 8). By September 2025, five documents had already been published, suggesting a sustained upward trend [Figure 1]. Among the retrieved documents, original articles constituted 97.9% (n = 46), whereas only one review article (2.1%) was identified.

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Figure 1:

Annual trend of Scopus-indexed arthroscopy publications from Nepal between 2010 and 2025 (n = 47).

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Source journals

The 47 documents were distributed across 17 journals. The Journal of the Nepal Medical Association published the highest number (n = 12), followed by the Journal of Nepal Health Research Council (n = 8), and Arthroscopy Techniques (n = 6). Other notable outlets included Kathmandu University Medical Journal (n = 4), BMC Musculoskeletal Disorders (n = 2), and Journal of Bone and Joint Surgery case connector (n = 2) [Table 1].

Institutional contributions

A total of 59 organizations were involved in publications. Of these, a full count of Bibliographic coupling among institutions reveals that 16 institutions were interconnected, forming 4 clusters with 29 links and a total link strength of 180. The leading institutions were the National Academy of Medical Sciences (n = 5), Kathmandu University School of Medical Sciences (n = 5), Nepalese Army Institute of Health Sciences (n = 3), Grande International Hospital (n = 3), and National Trauma Center (n = 3) [Figure 2 and Table 2].

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Figure 2:

Network visualization of institutional contributions to arthroscopy research from Nepal (2010–2025). A full-counting analysis of Bibliographic coupling among institutions reveals a total of 59 institutions, with 16 connected institutions forming 4 clusters, 29 links, and a total link strength of 180.

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International collaborations

Nepal collaborated with 41 countries in arthroscopy-related publications. Full-counting analysis of co-authorship networks revealed two major clusters, with 820 links and a total link strength of 833. Domestic authors accounted for the majority (Nepal, n = 47), with international contributions most frequently from China (n = 4), Thailand (n = 3), and the United States (n = 3). Other partners with at least two documents included Egypt, Indonesia, Nigeria, and South Korea [Figure 3 and Table 3].

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Figure 3:

Country-level collaboration network in Nepalese arthroscopy research (2010–2025). A full-counting analysis of co-authorship of countries revealed that Forty-one countries contributed, forming 2 clusters, 820 links, and a total link strength of 833.

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Author productivity

A total of 143 authors contributed to the retrieved documents. Of these, the full-counting co-authorship analysis of authors identified 32 interconnected authors, forming 8 clusters with 127 links and a total link strength of 267. The most prolific authors were Joshi, A. (n = 13), Pradhan, I. (n = 13), Singh, N. (n = 12), and Basukala, B. (n = 11). Other key contributors included Bista, R. (n = 9), Sharma, R. (n = 7), and several authors with 4 publications each (Basi, A.; Khadka, S.K.; Rai, S.; Sherchan, B.) [Figure 4 and Table 4].

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Figure 4:

Network visualization of authors contributing to Nepalese arthroscopy research (2010– 2025). A full-counting analysis of co-authorship of authors revealed 143 authors, 32 of whom were interconnected, forming 8 clusters with 127 links and a total link strength of 267.

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Citation analysis

Out of the 47 documents, 29 were cited at least once, generating 219 total citations and an h-index of 10. The citation distribution demonstrated an increase over time, with the highest accumulation occurring between 2021 and 2024, which together accounted for more than half of the total citations [Figure 5]. The top 10 most-cited arthroscopy-related articles from Nepal are presented in Table 5.

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Figure 5:

Citation overview of Nepalese arthroscopy publications indexed in Scopus (2010–2025). Out of 47 documents, 29 were cited at least once, accumulating 219 citations and an h-index of 10.

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Comparison to South Asian countries

When arthroscopy research output from Nepal was compared with other South Asian countries for the period 2010–2025, notable differences were observed in both publication volume and citation impact [Table 6]. Nepal contributed 47 documents, of which 29 were cited at least once, totaling 219 citations and yielding an h-index of 10.

In comparison, India emerged as the most prolific country in the region, publishing 1,218 documents, of which 790 were cited at least once, generating 8,054 citations and an h-index of 36. Pakistan ranked second in output with 84 publications, 42 cited documents, 310 citations, and an h-index of 10, comparable to Nepal in terms of citation impact, despite a higher publication volume. Other countries showed minimal contributions: Bangladesh (10 publications, 8 cited, 77 citations, h-index 4), Sri Lanka (5 publications, 4 cited, 5 citations, h-index 1), Bhutan (1 publication, 1 citation, h-index 1), and Afghanistan (1 publication, 7 citations, h-index 1). No publications were identified from the Maldives during this period.

Publication growth

The total number of documents retrieved from Nepal was 47 over 15 years, averaging three publications per year. Research activity began only in 2010, with a marked increase after 2018, peaking in 2021 and 2024. Similar delayed growth patterns have been observed in other surgical subspecialties in Nepal and South Asia, where structured academic training programs and arthroscopy services became established relatively late compared to countries with advanced academics.^[21] By contrast, bibliometric analyses from high-output countries, such as the United States, China, and Japan, report several thousand arthroscopy-related publications over the past two decades, reflecting well-established clinical practice, advanced infrastructure, and funding support.^[5] For instance, a global bibliometric study on arthroscopy in 2015 reported over 7,000 publications, with the United States contributing nearly 35% of the total, whereas Nepal’s contribution remains <0.1% of global output.^[6] Still, it is also important to note that several arthroscopy-related articles from Nepal continue to be published in non-indexed journals, which may lead to an underrepresentation of the actual research volume in bibliometric analyses.^[22]

Document types and journals

Nearly all Nepalese publications were original articles (97.9%), while review articles and meta-analyses were scarce. This aligns with trends from other emerging countries where research is largely clinical and case-driven rather than synthesis-based.^[23] Journals such as the Journal of the Nepal Medical Association and the Journal of Nepal Health Research Council served as the primary dissemination platforms, emphasizing reliance on national journals with relatively low impact factors. In comparison, high-output countries publish widely in specialized international journals such as Arthroscopy: The Journal of Arthroscopic and Related Surgery and Knee Surgery, Sports Traumatology, Arthroscopy, both of which are leading sources of high-impact citations.^[24,25]

Institutional and author productivity

The analysis showed 59 contributing institutions, of which 16 were connected in 4 collaborative clusters. The National Academy of Medical Sciences and Kathmandu University School of Medical Sciences were the most prolific institutions, reflecting their central role in postgraduate training and surgical research. An important observation was the scattered representation of B and B Hospital, which appeared under multiple variations in the database, such as “B & B,” “B and B,” and “AKB.” This lack of uniformity fragmented its publication record, causing its output to appear lower than its actual contribution, and highlighting the need for standardized institutional identifiers in bibliometric analyses. At the individual level, a small group of authors, particularly Joshi, A., Pradhan, I., Singh, N., and Basukala, B., accounted for a large share of total publications, consistent with the “Matthew effect” often described in bibliometrics, where productivity is concentrated among a few established researchers.^[26] Similar dominance by a small cohort of authors has been documented in Indian arthroscopy research, where fewer than 10 authors contribute over 40% of total publications.^[20]

International collaborations

Nepal’s arthroscopy research demonstrated collaborations with 41 countries, but the total link strength (833) remained modest compared to global benchmarks. The majority of publications were domestic, with limited but growing collaborations with China, Thailand, and the United States. This contrasts with India and China, which demonstrate much broader collaborative networks involving Europe and North America. Notably, bibliometric evidence suggests that international collaborations increase citation impact and visibility; hence, strengthening such ties is essential for Nepalese research to reach global audiences.^[5,27]

Citation impact

Of the 47 retrieved documents, 29 were cited, accumulating 219 citations and an h-index of 10. Although the overall citation density remains low compared to global arthroscopy literature, it reflects growing visibility, particularly after 2018. The citation pattern mirrors regional bibliometric studies, where resource-limited publications frequently achieve lower citation rates due to limited indexing in high-impact journals and reduced international reach.^[28] Nepal’s trajectory is encouraging, with recent articles published in arthroscopy techniques gaining international attention.^[29-31]

Comparative perspective

When benchmarked against regional and global outputs, Nepal’s arthroscopy research remains at an early stage of development. Between 2010 and 2025, Nepal contributed 47 publications, with 29 cited documents, 219 citations, and an h-index of 10, reflecting modest output but meaningful citation impact. In comparison, India led the region with 1,218 publications, 8,054 citations, and an h-index of 36, followed by Pakistan with 84 publications and an h-index of 10. Smaller countries such as Bangladesh (10 publications, h = 4), Sri Lanka (5 publications, h = 1), Bhutan (1 publication, h = 1), and Afghanistan (1 publication, h = 1) showed limited research activity, while the Maldives had no publications. At the global level, more than 48,000 documents were indexed during the same period, and China contributed 4,906 publications with an h-index of 56.

Three important patterns emerge from this comparison. First, Nepal’s contribution accounts for <0.1% of global arthroscopy literature, compared to approximately 2.5% for India and 10% for China, reflecting differences in research infrastructure, funding, and academic priorities. Second, the citation density of Nepalese publications (~4.7 citations per article) is lower than that of India (~6.6) and China (~7.3), suggesting limited international visibility, often due to publication in local or regional journals with modest impact factors. Third, the h-index of Nepal (10) remains modest compared to India (36) and China (56), underscoring fewer high-impact publications and limited long-term influence on the field.

Despite these disparities, the rise in Nepal’s output since 2018 indicates increasing academic engagement and growing research visibility. Overall, South Asia’s arthroscopy research is concentrated in India and Pakistan, with Nepal emerging as a secondary contributor.^[21] Strategic initiatives such as strengthening international collaborations, multicenter studies, and targeting high-impact journals could further enhance Nepal’s regional and global influence.^[32]

Although the growth trajectory of arthroscopy-related research in Nepal appears to parallel the increasing global trend in minimally invasive surgery, direct quantitative comparison with other countries was not undertaken in this study. Future bibliometric analyses applying identical search strings and databases across South Asian and global contexts would provide more robust and replicable insights. Hence, regional comparisons in this paper are presented only for contextual understanding and should not be interpreted as statistically validated differences.

Policy and educational implications

The findings of this bibliometric analysis provide actionable insights for academic societies, policymakers, and medical educators in Nepal. The concentration of arthroscopy-related publications in a few institutions and journals underscores the need for broader participation and research integration across orthopedic centers nationwide. Academic societies such as the Nepal Orthopedic Association and the Arthroscopic Society of Nepal can play a pivotal role by fostering multi-institutional research networks, organizing structured arthroscopy research workshops, and creating dedicated interest groups to mentor early-career surgeons. Similarly, medical schools and postgraduate training programs should incorporate formal modules on clinical research methodology, data interpretation, and scientific writing to strengthen research literacy. Encouraging collaborative projects with regional and international partners – especially with frequently collaborating countries such as China, Thailand, and the United States – can enhance visibility and citation impact. Furthermore, promoting open-access publication and improving the indexing of local journals such as the Journal of the Nepal Medical Association and Journal of Nepal Health Research Council can increase global discoverability of Nepali research. Collectively, these measures can elevate both the academic profile of Nepalese arthroscopy research and its translation into clinical practice.

Future directions

To strengthen arthroscopy research in Nepal, several steps are needed. Expanding collaborative networks, both regionally with India and China and internationally with countries with advanced academics, will help enhance methodological rigor and citation visibility.^[7] Encouraging multicenter studies and randomized controlled trials could generate higher-level evidence, while prioritizing submission to high-impact international journals would improve reach and citation performance.^[27] Investment in research training, mentorship, and funding mechanisms at institutional and national levels is crucial to sustain the momentum.^[33] Finally, integrating arthroscopy research into broader orthopedic and sports medicine initiatives may create opportunities for Nepalese authors to participate in large-scale collaborative projects, thereby narrowing the gap with regional leaders and contributing more meaningfully to global arthroscopy literature.^[23]

Strengths and limitations

This study has several strengths. To the best of our knowledge, it is the first bibliometric analysis of arthroscopy research from Nepal, offering a comprehensive overview of publication trends, authorship patterns, institutional contributions, and international collaborations over 15 years. The use of the Scopus database, one of the largest and most widely recognized bibliometric platforms, provided reliable indicators such as citation counts, h-index, and co-authorship networks. These metrics also allowed direct benchmarking with regional and global outputs, thereby placing Nepal’s contribution within a broader context. Furthermore, the analysis identified emerging trends, such as the increase in publications after 2018 and the appearance of Nepalese studies in internationally indexed journals. By highlighting challenges such as fragmented institutional naming and relatively low citation density, the study also provides actionable insights to guide the future direction of arthroscopy research in Nepal. These findings not only map the trajectory of arthroscopy research in Nepal but also provide insights for comparable emerging research systems aiming to strengthen visibility, collaboration, and academic infrastructure.

At the same time, some limitations must be acknowledged. First, the reliance on a single database (Scopus) may have led to underrepresentation of the actual research volume, as publications in non-indexed journals were excluded. Second, institutional name inconsistencies and fragmented data potentially lower the apparent contribution of active centers. Third, citation metrics are dynamic, and newer publications may not yet have accumulated sufficient citations to reflect their long-term impact. Finally, this study focused on quantitative bibliometric indicators without evaluating the qualitative aspects of research, such as methodological rigor, innovation, or clinical relevance, which are equally important in understanding the maturity of a research field.