Clinical and basic research has driven the advances in orthopaedics to a level only dreamed about a few decades ago, with major benefits for patients with musculoskeletal disorders. However, the picture is not perfect. Since I have been Editor-in-Chief of JBJS, I have become aware that some negative trends threaten the quality and veracity of some research being reported today. In this final issue for which I am Editor-in-Chief, I will address some of these threats.

Conflicts of interest have been a prominent topic among orthopaedic surgeons for many years, with the lay press focusing public attention on the relationships between industry and the clinical practice and research work of individual orthopaedists. Despite the disclosures of potential conflicts by JBJS and other journals, the impact of these disclosures remains small. My sense is that few of our readers look at the conflict-of-interest forms that are attached to all JBJS articles and that most accept some conflicts of interest as being the norm among those doing and reporting research. The trust that orthopaedic surgeons place in their colleagues to be free of influence from potential conflicts is concerning, as there is clear evidence that biases can and do result from conflicts of interest. We need to educate our readers to be more alert to these conflicts and to devise a better way to communicate the magnitude of the relationships that authors may have.

The pressure in American and international academic communities to publish can be intense, with publications in journals with higher impact factors constituting a major component for academic promotion. Over the past few years, several manuscripts representing attempts at duplicate publication or simultaneous submission have been identified by the software used at JBJS to detect some of these unethical publication practices, including less obvious sorts of plagiarism. While the publication of the same data in different languages was once considered acceptable, this is no longer the case, and the technology now available can more easily detect attempts at duplicate publication.