Retraction Watch

Tracking retractions as a window into the scientific process

Multiple retractions as brazen plagiarist victimizes orthopedics literature

with 14 comments

Several journals in the field of orthopedics and related disciplines have been victimized by an apparent serial plagiarist.

The author, Bernardino Saccomanni, of Gabriele D’ Annunzio University, in Chieti Scalo, Italy—across the boot and up a bit from Rome—appears to have lifted significant amounts of text in several articles.

Last January, for example, Current Reviews in Musculoskeletal Medicine, a Springer title, retracted a 2010 article by Saccomanni, “Painful os intermetatarseum in athletes: a literature review of this condition is presented,” after determining that it plagiarized a 2007 article in the Archives of Orthopaedic Trauma Surgery, also from Springer, with a very similar title, “Painful os intermetatarseum in athletes: report of four cases and review of the literature.”

Osteoporosis International, another Springer publication, has retracted a 2011 paper by Saccomanni titled “Vertebroplasty: an international point of view on this “minimally invasive” surgical technique,” after evidently learning that the point of view wasn’t exactly Saccomanni’s to begin with.

Turns out, it wasn’t the first time Saccomanni had expressed that view, either. Clinical Rheumatology, yet another Springer pub, has retracted a 2010 article of his with the remarkably similar title “Vertebroplasty: a point of view on this surgical treatment.”

Whose views were they? That would be Gunnar B.J. Andersson, of Rush University Medical Center in Chicago. Andersson is the author of a 2009 article in Nature Reviews Rheumatology, that seems clearly to be the source of Saccomanni’s words. (Saccomanni also lifted a bit from a 2009 paper in The Spine Journal, “Vertebroplasty and kyphoplasty for the treatment of vertebral compression fractures: an evidenced-based review of the literature.

Consider:

Saccomanni, in Clinical Rheumatology:

So, what can we deduce from these new results? Certainly, the studies suggest that patients with chronic back pain and a vertebral fracture should not automatically undergo a vertebroplasty, as the cause of a patient’s pain cannot always be attributed to the fracture. Interventional radiologists, although technically superb, are rarely trained to evaluate the source of back pain. Careful selection of patients by physicians with broad expertise in the management of spinal disorders could produce different results. Neither of these two articles mentions the presence of concomitant, potentially painful disorders of the spine, and the exclusion criteria fail to eliminate common spinal disorders such as degenerative changes, stenosis or spondylolisthesis.

Andersson (whose paper is neither cited nor referenced by Saccommani):

So, what can we deduce from these new results? Certainly, the studies suggest that patients with chronic back pain and a vertebral fracture should not automatically undergo a vertebroplasty, as the cause of a patient’s pain cannot always be attributed to the fracture. Interventional radiologists, although technically superb, are rarely trained to evaluate the source of back pain. Careful selection of patients by physicians with broad expertise in the management of spinal disorders could produce different results. Neither of these two articles mentions the presence of concomitant, potentially painful disorders of the spine, and the exclusion criteria fail to eliminate common spinal disorders such as degenerative changes, stenosis or spondylolisthesis.

Saccomanni, in Clinical Rheumatology:

In conclusion, vertebroplasty is likely to be unnecessary for a subgroup of patients with painful osteoporotic fractures. As is true in many areas of spinal care, careful patient selection is paramount to the success of any intervention. We need to better define who will truly benefit from surgery and not use this approach indiscriminately. Comparative effectiveness studies of vertebroplasty and other similar procedures are under way, and should be helpful in this regard.

Andersson, who evidently agrees:

In conclusion, vertebroplasty is likely to be unnecessary for a subgroup of patients with painful osteoporotic fractures. As is true in many areas of spinal care, careful patient selection is paramount to the success of any intervention. We need to better define who will truly benefit from surgery and not use this approach indiscriminately. Comparative effectiveness studies of vertebroplasty and other similar procedures are under way, and should be helpful in this regard.

Andersson said he found out about the copycatting from the editors of Nature Reviews Rheumatology, who wrote him to alert him to the plagiarism—and to apologize.

 I thought literally every word was the same

said Andersson, who added that although he didn’t get worked up about the incident at the time,

I am generally upset about people doing this because it is theft, no matter how you look at it.

Clinical Rheumatology also has retracted Saccomanni’s 2010 paper, “Total elbow arthroplasty: history, current concepts, and future,” the abstract of which is virtually identical to a 2006 article by Stephen Trigg, a Mayo Clinic orthopedic surgeon, in Northeast Florida Medicine.

That’s not all. A Medline search of Saccomanni’s name came up with about a dozen citations (including the retraction from Current Reviews in Musculoskeletal Medicine). One of those publications was a 2008 letter in the Archives of Orthopaedic and Trauma Surgery Including Arthroscopy and Sports Medicine (a Springer-Verlag title) in response to a 2003 article in the Hong Kong Journal of Orthopaedic Surgery.

We Googled the text of Saccomanni’s letter:

It was interesting to read the article by Ng et al. in a issue of the Hong Kong Journal of Orthopaedic Surgery [1]. The authors have described a review of five patients with anterior dislocation of the hip after having undergone a total hip replacement by the posterior approach.

While it is accurately mentioned in the article that it is rare to find anterior dislocation after using the posterior approach for total hip arthroplasty, I fail to understand why the article is titled ‘aetiology and treatment’ because the described aetiology is nothing but a complication of excessive anteversion, which is well known. The cause of three of the reported five cases was established by fluoroscopy. It would be of interest to other readers also to know why such a definitive aetiological factor was not investigated for the two other patients, especially when such cases are reported. Also, I would like to highlight that, in all these reported cases, the approach had nothing to do with the type of dislocation (anterior). Rather, as the authors themselves mention, the anterior dislocations were only because of the high angle of anteversion, which was wrongly done during the surgery. I appreciate the fact that authors have reported their avoidable complications as a scientific paper. The rehabilitation and treatment protocol after any such adversity is nicely described in this article and is quite informative.

And found this [note–pdf]:

Dear Sir,

It was interesting to read the article by Ng et al in a recent issue of the Hong Kong Journal of Orthopaedic Surgery.1 The authors have described a review of 5 patients with anterior dislocation of the hip after having undergone a total hip replacement by the posterior approach.

While it is accurately mentioned in the article that it is rare to find anterior dislocation after using the posterior approach for total hip arthroplasty, I fail to understand why the article is titled ‘aetiology and treatment’ because the described aetiology is nothing but a complication of excessive anteversion, which is well known. The cause of 3 of the reported 5 cases was established by fluoroscopy. It would be of interest to other readers also to know why such a definitive aetiological factor was not investigated for the 2 other patients, especially when such cases are reported.

Also, I would like to highlight that, in all these reported cases, the approach had nothing to do with the type of dislocation (anterior). Rather, as the authors themselves mention, the anterior dislocations were only because of the high angle of anteversion, which was wrongly done during the surgery.

I appreciate the fact that authors have reported their avoidable complications as a scientific paper. The rehabilitation and treatment protocol after any such adversity is nicely described in this article and is quite informative.

That letter appeared in 2003, and was signed by a Dr. KM Marya, of SSR Medical College, in Belle Rive, Mauritius.

Somehow, we get the sense that we could do this all day with his papers and produce similar results.

We emailed Saccomanni for comment and received this reply:

WHICH ARTICLES?

When we specified, he responded:

my papers are original.

My papers have been published after three revisions!!!

Now, Saccomanni’s first point speaks for itself, but we do have a few thoughts about his second statement.

Clearly, the screening process at Clinical Rheumatology and Osteoporosis International (which has given Saccomanni a lifetime publishing ban) failed. We’ve argued before that if reporters can find plagiarized text with Google, major publishers ought to be able to do it in their sleep using internal databases (let alone services like CrossCheck, etc.). For Saccomanni to have been able to slip two, virtually identical papers into journals belonging to the same publishing company is bad enough. For both of them to have plagiarized so obviously is even worse.

We hope that, if Springer doesn’t already mandate that every one of its titles use a third-party plagiarism-detection service, in addition to whatever internal controls are already in place (please say there are some!), it starts doing so now.

Comments
  • JudyH December 22, 2011 at 12:24 pm

    “in addition to whatever internal controls are already in place (please say there are some!)”

    I adore this. You know there are none in place. How could the editors have missed such blatant plagiarism of articles published in their own journals if they were making even the smallest effort at screening for plagiarism? As you pointed out, a free Google search found the sources. 🙂 Publishing is a business. The maximum output with the minimum input is what Springer aims for. Not that other institutions are more vigilant. Universities, for example …..

  • Anonymous December 22, 2011 at 1:42 pm

    The evidence strongly suggests that Springer doesn’t use CrossCheck until someone raises questions. The situation here seem similar to the recent blog entry here about serious plagiarism in the Springer journal “Meccanica.” I wonder if this is simply corner-cutting (I suppose every paper checked via CrossCheck costs a few pennies) or if it is a symptom of a deeper problem?

  • Annie December 22, 2011 at 2:34 pm

    Graft fixation alternatives in anterior cruciate ligament reconstruction, Muskuloskelet. Surg. 2011 Dec; 95(3):183-191.

    I don’t have access to the whole article, but the abstract is essentially identical as the abstract in another article with the identical title:

    R. Robbe and D.L. Johnson. Graft fixation alternatives in anterior cruciate ligament reconstruction, Univ. Pennsylvania Orthopaedic Journal, 2002, 15:21-27

    • Gerry December 22, 2011 at 9:25 pm

      This is amazing. The article is practically a carbon copy of the original. The funny thing is that the bits added by the plagiarist are obvious because the standard of English is poorer. This is the conclusion of the two papers.

      Original:
      Graft fixation continues to be the weak link early in the
      rehabilitative process. This fixation strength guides the
      postoperative regimen in that rehabilitation and reintroduction
      of activities should correlate with fixation strength
      achieved in the operating room. Although clinical results are
      good with most fixation techniques, significant differences
      continue to be demonstrated in the laboratory. The clinical
      relevance of these differences is not completely known. In
      general, aperture fixation provides advantages over distal
      fixation. Interference screws are the only methods providing
      fixation close to the articular surface. Some other methods
      have demonstrated improved strength and stiffness, but distal
      fixation should always arouse concern for graft-tunnel
      motion. Ultimately, the fixation choice depends upon surgeon
      comfort, however knowledge of available options
      should be present.

      New:
      The graft fixation is a valid alternative
      method described in literature. We believe that many
      surgeons have shown good clinical results with less fixation
      strength [17, 18].
      Graft fixation continues to be the weak link early in the
      rehabilitative process. This fixation strength guides the
      postoperative regimen in that rehabilitation and reintroduction
      of activities should correlate with fixation strength
      achieved in the operating room. Although clinical results
      are good with most fixation techniques, significant differences
      continue to be demonstrated in the laboratory. The
      clinical relevance of this is not completely known. In
      general, aperture fixation provides advantages over distal
      fixation. Interference screws are the only methods providing
      fixation close to the articular surface. Some other
      methods have demonstrated improved strength and stiffness,
      but distal fixation may be associated with graft-tunnel
      motion. The figures are not documented in this paper.
      Ultimately, fixation choice may depend on the surgeon’s
      comfort level, but it is most important in the outcome.

  • Annie December 22, 2011 at 2:55 pm

    Another one:

    Inflammation and shoulder pain — a perspective on rotator cuff disease, adhesive capsulitis, and oseoarthritis: conservative treatment. Clin. Rheumatol. 2009 May; 28(5):495-500.

    Significant overlap with:

    T.A. Blaine. Inflammation and Shoulder Pain — A perspective on rotator cuff disease, adhesive capsulitis, and oseoarthritis. U.S. Muskuloskeletal Review, 2005:46-49.

  • Annie December 22, 2011 at 3:20 pm

    Yet another:

    An atypical aneurysmal bone cyst of the head of the humerus, arthroscopic treatment: a case report. Arthroscopy and Sports Medicine, 15 November 2007.

    The above article describes one case. Yet there is significant overlap and word-for-word copying throughout compared to the following article, which describes four cases (Saccomanni’s case most closely copies case #2):

    Otsuka et al. A new treatment of aneurysmal bone cyst by endoscopic curretage without bone grafting. Arthroscopy. 17(7). September 2001.

  • Annie December 22, 2011 at 4:04 pm

    A second article of his in Curr. Rev. Musculoskeleto. Med. was also retracted due to plagiarism. Localized synovial hypertrophy in teh anteromedial compartment of the osteoarthritic knee. 2011. 4(1):34.

    From the retraction notice:

    This article has been withdrawn due to plagiarism. The original work is McGuire DA (2006). Meniscal Impingement Syndrome Versus Localized Synovial Hypertrophy? Arthroscopy 22:1368.

    I apologize if you mentioned this one already (it’s getting hard to keep track of all of the articles.)

  • Annie December 22, 2011 at 4:22 pm

    Also retracted:

    ACL prosthesis: any promise for the future? Knee Surgery, Sports Traumatology, Arthroscopy. 2010, 18(6):797-804.

    “This article has been retracted due to plagiarism.”

  • Annie December 22, 2011 at 4:25 pm

    Also retracted:

    Unicompartmental knee arthroplasty: a review of literature. Clin. Rheumatol. 2010, 29(4):339-346.

    “This article has been retracted due to plagiarism.”

  • Annie December 22, 2011 at 4:35 pm

    Low back pain associated with pregnancy: a review of literature. Eur. Orthopaedics and Traumatology. 2011, 1(5):169-174.

    With the exception of the abstract and summary, this article is identical to:

    J. Sabino and J.N. Grauer. Pregnancy and low back pain. 2008. Curr. Rev. Musculoskelet. Med. 1(2):137-141.

    Now I understand why Saccomanni’s response was “WHICH ARTICLES?” He probably can’t keep track of which articles have already been retracted, which ones he copied but the plagiarism hasn’t been detected yet, and which ones he (gasp!) may have actually written himself.

    • dollarbinblues December 22, 2011 at 5:27 pm

      Somehow, I think he can keep track of that last category quite easily…

  • hck December 23, 2011 at 3:16 am

    Bernardino Saccomanni is *not* on the list of persons teaching medicine at that university: http://www.unich.it/unichieti/appmanager/federati/medicina?_nfpb=true&_pageLabel=Personale_medicinaFirstPage_v2

  • Neuroskeptic December 23, 2011 at 7:27 am

    He’s a plagiarist – make no bones about it.

  • Jessica G December 27, 2011 at 4:19 pm

    Surely there must be more details for repercussions — For Clinical Rheumatology and Osteoporosis International retracting the articles, and Saccomanni’s lifetime publishing ban — that I am not able to find online? So little coverage for such unethical research and acts of plagiarism.

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