Background: Given the strong influence of thoughts, emotions, and behaviors on musculoskeletal symptoms and
limitations it’s important that both scientific and lay writing use the most positive, hopeful, and adaptive words and
concepts consistent with medical evidence. The use of words that might reinforce misconceptions about preferencesensitive
conditions (particularly those associated with age) could increase symptoms and limitations and might also
distract patients from the treatment preferences they would select when informed and at ease.
Methods: We reviewed 100 consecutive papers published in 2014 and 2015 in 6 orthopedic surgery scientific journals.
We counted the number and proportion of journal articles with questionable use of one or more of the following words:
tear, aggressive, required, and fail. For each word, we counted the rate of misuse per journal and the number of specific
terms misused per article per journal
Results: Eighty percent of all orthopedic scientific articles reviewed had questionable use of at least one term. Tear
was most questionably used with respect to rotator cuff pathology. The words fail and require were the most common
questionably used terms overall.
Conclusion: The use of questionable words and concepts is common in scientific writing in orthopedic surgery. It’s
worth considering whether traditional ways or referring to musculoskeletal illness merit rephrasing.