A Bibliometric Analysis and Visualisation of Research Trends in Allergy of hip-implants

A diversified set of metals are used for hip-implants. The bibliometric analysis had been conducted to understand the active authors, organizations, journals, and countries involved in the research domain of “Allergy of hip-implants”. All published articles related to “Allergy of hip-implants” from “Scopus”, were analyzed using the VOS viewer to develop analysis tables and visualization maps. This article had set the objective to consolidate the scientific literature regarding “Allergy of hipimplants” and also to find out the trends related to the same. The most active journals in this research domain were the Acta Orthopaedica and Journal of Orthopaedic Surgery and Research. The most active countries were the United States of America and the United Kingdom. The leading organization engaged in the research regarding allergy of hip-implants was the Hospital of Special Surgery, United States of America. The most active author who had made valuable contributions related to the allergy of hip implants was Thomas P.


Introduction
An engineered medical device to replace a missing or damaged biological structure is known as an implant. Different types of metals and materials are used to create implants. The allergy to metal implants is a serious issue to be addressed. Metal releases from implants cause various types of allergies and hypersensitivity [1] [2]. The safety of the material used is an important determinant while choosing implants [3]. Material engineering and surface engineering can play a significant role in improving safety and reducing allergies associated with metal implants [4].
Allergy of Nickel implants had been reported regarding hip implants [5] Allergy of Nickel-based total hip arthroplasty [6]. Hypersensitivity to Nickel can be in cases of orthopedic implants or delayed hypersensitivity among patients who underwent a hip replacement. Such patients may with pain, fatigue, and contact allergic dermatitis, and instability [7]. Chances for postoperative hypernickelemia and nickeluresis should be counted in cases of the nickel-based porous-coated knee or hip prostheses [8]. The issue of hypersensitivity had been reported in hip implants based on cobalt-chromium alloys [9]; [10]. Similarly, allergic skin disease is another issue associated with patients who underwent hip replacement with metal-on-metal (MOM) bearings. This happens due to corrosion and the release of wear debris and high levels of metal ions in the blood [11].
Stainless steel is often considered a safe metal for hip implants in comparison with Nickel [12]. The Zirconium implants are known for high resistance to fracture and flexural strength, lower levels of allergies, and excellent biocompatibility [13]. Titanium is one of the widely used metals for hip implants. The release of Titanium particles from the bio-implants may lead to bone losses in addition to Titanium allergy [14] [15].
This bibliometric analysis will be a useful platform for future researchers by realizing the top researchers, organizations, and countries involved in research regarding allergies of hip-implants [16]. This article is arranged into four sections. The first section is the introduction, followed by the discussion of the methodology by which the research was conducted. The third section deals with results and discussion. The fourth section deals with the conclusion. The following research objectives and research questions were framed for conducting bibliometric analysis systematically.

Research Methodology
Scopus files had been used for this article. For the article selection, the Boolean used was TITLE-ABS (Allergy hip-implants) on 08/03/2021. All the tables in this paper were created by using Microsoft Excel and VOS Viewer. Grammarly was used for spelling and grammar checks. Mendeley was used for article review and citation. This paper had been inspired by bibliometric analysis in its presentation style, analysis, and methodology from the works [17]- [23].

Results and discussion 3.1 Results
This first round of search produced an outcome of 66 documents, in six languages, out of which 45 documents were in English. The classification of document categories is shown in Figure 1. For improving the quality of the analysis, we had selected only the peer-reviewed articles and all other documents had not been considered. Thus after using filters "Article" and "English" the second round search produced an outcome of 25 English articles (both open access and others) and had been used to conduct bibliometric analysis and visualization using VOS Viewer. The English research articles in this domain since 1988 had been shown in Figure 2.     5 14 In Co-occurrence analysis, we had used all keyword analyses, by keeping the minimum number of occurrences of a keyword as 5. This combination plotted the map of 30 thresholds, in three clusters. The overlay visualization of co-occurrence analysis of keywords has been shown in Figure 4.  Co-authorship analysis of the countries engaged in the research on "Allergy of hip-implants" had been shown in Figure 5. The overlay visualization map of co-authorship analysis plotted in Figure 5, points out the main countries with their strong co-authorship linkages and clusters involved.  Link analysis and citation analysis were used to identify the most active journal in this research domain. We have taken the parameters of the minimum number of documents of a journal as one and the minimum number of citations of a journal as one for the link analysis and citation analysis. Highlights of the most active and relevant journals related to "Allergy of hip-implants" are shown in table 4. Table 4 shows the journal activity of this research domain through parameters of publication volume, citations, and co-authorship linkages. From the above discussion regarding the bibliometric patterns in the research regarding the allergy of hipimplants, this research had observed a gradual increase in research interest regarding allergy of hip-implants from the starting of the millennium and the momentum is going on positively. This points out the relevance and potential of this research domain (Refer to Figure 2). The most active author in this research domain was Thomas P. with the highest publication, citations, and co-authorship links (Refer to table 1). The overlay analysis of top countries researching allergy of hip-implants indicates that the United States of America and United Kingdom were the leading countries relating to the highest number of publications; and citations and co-authorship links respectively (Refer to figure 5). The top journals of this research domain were identified as the Acta Orthopaedica and Journal of Orthopaedic Surgery and Research. From these wide sources of information, researchers can focus on top journals where they can identify the most relevant and highly cited articles regarding allergy hip-implants.

Conclusion
Allergy of hip-implant was an interesting research domain and the most active journal related to this research domain was the Acta Orthopaedica and Journal of Orthopaedic Surgery and Research. The most active countries were the United States of America and the United Kingdom. The leading organization engaged in the research regarding allergy of hip-implants was the Hospital of Special Surgery, United States of America. The most active author who had made valuable contributions related to the allergy of hip implants was Thomas P. This research domain offers a new avenue for researchers and future research can be on innovations in allergy of hip-implants.