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. 2024 Jun 21;10(13):e33406. doi: 10.1016/j.heliyon.2024.e33406

Bibliometric analysis of synovial in osteoarthritis in the last 10 years

Guangtao Han 1, Lijun Cai 1, Bohua Li 1, Qianhao Li 1, Yue luo 1, Qiuru Wang 1, Pengde Kang 1,⁎
PMCID: PMC11259837  PMID: 39035546

Abstract

Background

Our aim was to examine trends in the bibliometric analysis of synovial for osteoarthritis over the last 10 years.

Methods

Publications relevant to synovial in osteoarthritis from 2013 to 2022 were retrieved from the Science Citation Index Expanded (SCI-E), Social Sciences Citation Index (SSCI), and Web of Science Core Collection (WoSCC) databases. The countries/regions, institutions, authors, journals, references, and keywords related to this topic were extracted using Citespace and Vosviewer. Citespace and Vosviewer were also used to identify and analyze this field's research hotspots and trends.

Results

Over the past 10 years, 5738 articles addressing the role of synovium in osteoarthritis have been published. Between 2013 and 2022, 2021 had the highest amount of published articles (a total of 756 published articles, or 13.18 % of the total articles) covering synovial in osteoarthritis. China was the country that published the most articles, while Duke University was the institution that published the most articles. Osteoarthritis and Cartilage was the journal with the most publications related to the study of Synovium in osteoarthritis. The National Nature Science Foundation of China provided the most funding. According to the analysis of keyword burst detection, human cartilage, control experiment, and exosomes were the most searched at different points in time.

Conclusion

In the last ten years, both the number of citations and the article discussing synovial in osteoarthritis have increased. The top 10 most searched keywords were “osteoarthritis","synovial fluid”, “inflammation”, “cartilage”, “expression","rheumatoid arthritis","articular cartilage”, “knee osteoarthritis”, “synovial”, “knee". According to the timeline view of co-citation clustering, synovial components and their expressions have emerged as hotspots of research associated with synovial osteoarthritis.

Keywords: Bibliometric analysis, Citespace, Vosviewer, Synovial, Osteoarthritis

1. Introduction

Osteoarthritis, a chronic osteojoint disease, is typified by subchondral osteosclerosis, osteophyte generation, progression of articular cartilage deterioration, and joint inflammation [1]. Osteoarthritis is by far the most prevalent form of arthritis, and its causes are related to age, obesity, joint overstrain, joint deformity, and other factors [2]. The main clinical manifestations of osteoarthritis are chronic pain and joint mobility disorders, which can impact the patient's quality of life [3]. Osteoarthritis is most common in middle-aged individuals and the elderly [4]. Previous studies have linked the deterioration of cartilage to osteoarthritis. As the study progressed, researchers found that the synovial membrane played a smaller role in osteoarthritis than in rheumatoid arthritis, but it was essential [5]. Histopathology in the 1980s indicated that although features of synovial inflammation (excessive cell proliferation, increased angiogenesis, and the presence of lymphocyte aggregation) were highly heterogeneous between patients, they were associated with pain and osteoarthritic progression from osteoarthritis [6]. Moreover, the thickness of synovial tissue hyperplasia in osteoarthritis patients was related to the degree of inflammatory cell infiltration. Moreover, studies have shown that synovial macrophages have more significant infiltration in joints in the late stage of osteoarthritis than in the early stage of osteoarthritis [7]. Cytokines and inflammatory factors secreted by synovial macrophages, such as IL-1, IL-6, TNF and vascular endothelial growth factor, can be diffused into cartilage through synovial fluid to promote the apoptosis of chondrocytes and the invasion of new blood vessels in cartilage tissue [8]. It leads to the destruction and degradation of chondrocytes, aggravates joint wear and tear, and eventually leads to osteoarthritis. Synovial fluid and serum of patients with osteoarthritis contain a large number of synovial cells and products of chondrocyte metabolism. The above evidence proves that osteoarthritis is closely related to synovial membrane [7].

Bibliometric is a discipline introduced by Pritchard in 1969 that uses mathematical and statistical methods to quantitatively evaluate scientific publications, books, and other forms of literature [9]. Information from extensive sources can be quickly retrieved and assessed using this method, thereby helping researchers to identify research hotspots and development trends. Authors, Journals, countries, and institutions contributing to a particular field can also be evaluated further providing a basis for research. Furthermore, bibliometrics can be utilized to quantitively and qualitatively assess the trends in research [10]. Based on public databases, this approach can efficiently and precisely show the most significant research findings in a certain topic, offering a theoretical foundation for more study [11]. Moreover, decision-makers can also use this information as a source of reference [12]. A bibliometric analysis of the literature on osteoarthritis and synovial arthritis published between 2013 and 2022 was done in this work. The current development status, future research trends, and hotspots in this field were summarized based on the analysis results, offering guidance and references for further study.

2. Materials and procedures

2.1. Steps of material collection

The bibliometric analysis in this work was conducted using the Science Citation Index expanded and Social Science Citation Index of WoSCC database. The search phrase was set as follows:Topic=(synovial or synovium or synovialis and osteoarthritis). The publications extracted were only in English. A comprehensive database search of relevant publications published between 2013 and 2022 was conducted by Guangtao Han and Lijun Cai; only original articles and reviews were included in our analysis. Fig. 1 depicts a detailed flow chart of the selection procedure conducted in this research. On January 1, 2023, all publication searches and file downloads were carried out to prevent bias brought about by frequent database updates. In this study, two researchers evaluated the data input and collection independently. By conferring with field experts or holding discussions, the two researchers were able to come to a consensus regarding discrepancies in their findings.

Fig. 1.

Fig. 1

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Search strategy shown by a chart.

2.2. Bibliometric analysis

All of the WoSCC data was textualized and then imported into analysis software for analysis. To identify co-cited articles, keywords, countries, institutions, journals, authors, and keyword breakout network characteristics, we employed VOSviewer 1.6.16, CiteSpace 6.1R6, 64-bit, and bibliometrics online analysis platforms. The results were then visualized. The Journal Citation Report 2022 was used as the source of all impact factors and category quartiles.

In order to analyze the hotspots of synovial in osteoarthritis, CiteSpace software was used to analyze the literature, including the analysis of publishing institutions, co-citation literature as well as keywords with the most relevance. The objects to be analyzed are presented as nodes in the constructed network visualization map; the larger the nodes, the more frequently the objects occur. In addition, CiteSpace software is a good software for analyzing centrality. Centrality is an index to define the importance of network nodes. Centrality is proportional to the prominence of nodes. Not to be ignored, the significance of node location in a network can also be measured using centrality. The more connections through this node in the network, the higher its centrality.

With VOSviewer, a science-based knowledge network that highlights the development of research fields, institutional collaboration, and potential research hotspots can be establishedWe used the VOS viewer to construct a density map and conduct a visual analysis of keyword co-occurrence by analyzing the ksynovial hotspots associated with osteoarthritis. Co-occurrence analysis in the VOS viewer can divide keywords into different clusters that are color-coded. By using the keyword co-occurrence network to cluster the research hotspot, we can intuitively identify the development trend of the research hotspot.

3. Results

3.1. Overview of publications

A total of 5738 articles regarding the role of synovium in osteoarthritis have been published in the last 10 years (Fig. 1). Over 10 years, the number of articles on synovial in osteoarthritis increased, as did the number of citations (Fig. 2A). Between 2013 and 2022, the year with the largest number of published articles involving synovial in osteoarthritis was 2021, with 756 articles published in total, making up 13.18 % of all articles (Fig. 2B).

Fig. 2.

Fig. 2

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A.Number of citations of synovial in osteoarthritis research from 2013 to 2022. Fig. 2B.The number of articles published on synovial in osteoarthritis research between 2013 and 2022. Different colors represent different countries.

3.2. National distribution of synovial in osteoarthritis and distribution in research institutions

Fig. 3 shows the country collaborations of synovial studied in osteoarthritis research from 2013 to 2022, and Table 1 shows the top 20 country collaborations of synovial for articles studied in osteoarthritis research 2013–2022. We found that the country with the most studies of synovial in osteoarthritis 2013–2022 was China (1435), followed by the United States (1417), then the United Kingdom (419), Japan (407) and Germany (368). Of the total number of articles, 25.01 % were from China, making it the country with the highest research on synovial tissue in osteoarthritis. Nodes in the network are ranked according to their importance using the central value. The number of links through the node increases as the center value increases. The highest central value among these countries is 0.39 in the United States. It was followed by 0.24 in Italy, 0.18 in Germany, 0.12 in Australia and 0.1 in Japan. Table 1 shows that there was a weak correlation between the studies on synovial in osteoarthritis, with the central values of the remaining countries all being less than 0.1.

Fig. 3.

Fig. 3

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Synovial in osteoarthritis research from 2013 to 2022 of national collaboration.

Table 1.

Synovial in osteoarthritis research from 2013 to 2022 in top 20 countries.

Rank Counts Centrality Country
1 1435 0.09 PEOPLE R CHINA
2 1417 0.39 USA
3 419 0.1 ENGLAND
4 407 0.01 JAPAN
5 368 0.18 GERMANY
6 332 0.24 ITALY
7 276 0.08 NETHERLANDS
8 264 0.06 CANADA
9 241 0.06 SOUTH KOREA
10 174 0.12 AUSTRALIA
11 166 0.07 SPAIN
12 163 0.03 FRANCE
13 142 0.08 TAIWAN
14 134 0.08 SWEDEN
15 121 0.04 INDIA
16 119 0.05 SWITZERLAND
17 108 0.01 DENMARK
18 91 0.01 BRAZIL
19 86 0.03 BELGIUM
20 79 0.01 TURKEY
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In terms of research institutions, we found that the organization with the most studies on synovial in osteoarthritis from 2013 to 2022 was Duke Univ (98 papers), followed by China Med Univ (89 papers) and Univ Calgary (77 papers). Univ Med Ctr Utrecht ranked fourth with 68 articles and Southern Med Univ ranked fifth with 66 articles (Fig. 4). In terms of the central value, Hosp Special Surg ranked the first with 0.13, China Med Univ Hosp ranked the second with 0.11, and Duke Univ ranked the third with 0.1. The central values of other research institutions were all less than 0.1, indicating a weak correlation between research institutions on synovial in osteoarthritis (Table 2).

Fig. 4.

Fig. 4

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Synovial of osteoarthritis research from 2013 to 2022 with institutional collaboration.

Table 2.

Synovial in osteoarthritis research from 2013 to 2022 in top 20 institutions.

Rank Centrality Article Institutions
1 0.1 98 Duke Univ
2 0.06 89 China Med Univ
3 0.03 77 Univ Calgary
4 0.06 68 Univ Med Ctr Utrecht
5 0.06 66 Southern Med Univ
6 0.07 65 Univ Nottingham
7 0.05 64 Shanghai Jiao Tong Univ
8 0.03 64 Sun Yat Sen Univ
9 0.09 63 Lund Univ
10 0.07 62 Harvard Med Sch
11 0.05 58 Peking Univ
12 0.03 56 Tokyo Med & Dent Univ
13 0.06 55 Washington Univ
14 0.11 54 China Med Univ Hosp
15 0.13 54 Hosp Special Surg
16 0.03 52 Radboud Univ Nijmegen
17 0.07 51 Univ Padua
18 0.08 50 Rush Univ
19 0.05 49 Sichuan Univ
20 0.05 49 Brown Univ
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3.3. Author network analysis

We used vosviewer to analyze co-authors of synovial in osteoarthritis studies, and the results are shown in Table 3. The research results showed that Tang,Chih-Hsin published 53 articles at most, Sekiya and Ichiro published 47 articles ranked second, Koga, Hideyuki published 40 articles ranked third, Liu, Shan-Chi and Tsai, Chun-Hao published 35 articles tied for fourth. In terms of average citations, Mobasheri, Ali ranked first with 58.2, Kraus, Virginia B ranked second with 39.21, followed by Muneta, Takeshi ranked third with 28.72. The distribution of author collaboration is displayed in Fig. 5, demonstrating that the relationship among authors was rather fragmented. It follows that scholarly cooperation was generally insufficient and occurred infrequently.

Table 3.

Top 10 authors of synovial studies in osteoarthritis from 2013 to 2022.

Rank Author Publication Citations Citations/Publications
1 Tang, Chih-Hsin 53 1149 21.67924528
2 Sekiya, Ichiro 47 1122 23.87234043
3 Koga, Hideyuki 40 876 21.9
4 Liu, Shan-Chi 35 724 20.68571429
5 Tsai, Chun-Hao 35 827 23.62857143
6 Mobasheri, Ali 35 2037 58.2
7 Tsuji, Kunikazu 33 695 21.06060606
8 Muneta, Takeshi 29 833 28.72413793
9 Kraus, Virginia B. 29 1137 39.20689655
10 Takaso, Masashi 27 231 8.555555556
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Fig. 5.

Fig. 5

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Author diagram of synovial studies in osteoarthritis from 2013 to 2022.

3.4. Number of articles published in journals

In the recent 10 years, synovial studies in osteoarthritis was involved in many journals. OSTEOARTHRITIS AND CARTILAGE ranked first with 352 articles published in this journal, followed by 177 articles in ARTHRITIS RESEARCH THERAPY. JOURNAL OF ORTHOPAEDIC RESEARCH ranked third, INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES ranked fourth and PLOS ONE ranked fifth. In terms of the number of references per literature, ANNALS OF THE RHEUMATIC DISEASES ranked first, ARTHRITIS RHEUMATOLOGY ranked second, and ARTHRITIS RESEARCH THERAPY ranked third. OSTEOARTHRITIS AND CARTILAGE ranked fourth and PLOS ONE ranked fifth. Most of the journals were located in the JCR Q1, demonstrating the high influence of synovial studies in osteoarthritis (Table 4). Fig. 6 shows the relationship between journals of synovial studies in osteoarthritis from 2013 to 2022. These journals are closely connected, indicating more collaboration among them.

Table 4.

Top 10 journals of synovial studies in osteoarthritis from 2013 to 2022.

Rank Publications Article counts Citations Citations/Article IF Self-citation IF(except Self-citation rate) JCR
1 OSTEOARTHRITIS AND CARTILAGE 352 11857 33.68465909 7.507 8 % 6.90644 Q1
2 ARTHRITIS RESEARCH THERAPY 177 6032 34.07909605 5.606 2.20 % 5.482668 Q1
3 JOURNAL OF ORTHOPAEDIC RESEARCH 155 3118 20.11612903 3.103 5.60 % 2.929232 Q2
4 INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES 135 2266 16.78518519 6.208 9.70 % 5.605824 Q1
5 PLOS ONE 128 2681 20.9453125 3.752 3.80 % 3.609424 Q2
6 SCIENTIFIC REPORTS 105 2129 20.27619048 4.997 4.20 % 4.787126 Q2
7 ARTHRITIS RHEUMATOLOGY 97 4040 41.64948454 15.483 3.30 % 14.972061 Q1
8 BMC MUSCULOSKELETAL DISORDERS 87 1310 15.05747126 2.562 6.10 % 2.405718 Q3
9 CARTILAGE 68 512 7.529411765 3.117 8.70 % 2.845821 Q2
10 ANNALS OF THE RHEUMATIC DISEASES 67 3899 58.19402985 28.003 8.50 % 25.622745 Q1
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Fig. 6.

Fig. 6

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Journal relationship of synovial in osteoarthritis studies from 2013 to 2022.

3.5. Funding sponsorship

Synovial in osteoarthritis studies has been supported by many funds in recent 10 years, as shown in Table 5. At the top of the list of sponsored articles were the 715 articles sponsored by the National Nature Science Foundation of China; next in line were the 636 articles sponsored by the National Institutes of Health Nih USA and the United States Department of Health and Human Services; fourth place went to the Nih National Institute of Arthritis Musculoskeletal Skin Diseases (Niams) with 364 sponsored articles, and fifth place went to the European Commission with 264 sponsored articles. European countries and the USA made up the majority of the top 10 funders of synovial in osteoarthritis studies. However, the National Natural Science Foundation of China sponsored the most articles in this area during the last 10 years.

Table 5.

Top 10 journals of synovial studies in osteoarthritis from 2013 to 2022.

Rank Funding Agency Counts
1 National Nature Science Foundation of China 715
2 National Institutes of health Nih USA 636
3 United States Department of health Human Servives 636
4 Nih National Institute of Arthritis Musculoskeletal skin disease niams 364
5 European Commission 264
6 Ministry of education culture sports science and technology japan mext 188
7 Versus Arthritis 145
8 Japan society for the promotion of science 144
9 Uk research innovation Ukri 138
10 Medical research Council UK Mrc 103
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3.6. Keyword co-occurrence analysis

We performed co-occurrence analysis of synovial in osteoarthritis from 2013 to 2022 using vosviewer, and the results are shown in Fig. 7. The term “keyword co-occurrence analysis” describes how frequently two keywords occur together in a single article. The thickness of the line and the size of the circle represent the frequency of co-occurrences and keyword occurrences. We selected these keywords from 5738 articles in total. About 20436 keywords were selected for their frequency of co-occurrence, as they met the criteria (Fig. 7A). The top ten keywords of synovial in osteoarthritis were “osteoarthritis (n = 3352)", “synovial fluid (n = 1588)", “inflammation (n = 1159)", “cartilage (n = 1117)", “expression (n = 1114)", rheumatoid arthritis (n = 879) ", articular cartilage (n = 874) ", knee osteoarthritis (n = 868) ", synovial (n = 667) ", “knee (n = 596) "(Fig. 7A). Five clusters were divided into keyword co-occurrence:the expression of genes and pathway in synovial in osteoarthritis, synovial fluid's function in osteoarthritis diagnosis, the role of targeting synovial in the treatment of osteoarthritis, The clinical impact of synovial on osteoarthritis and their function in the pathogenesis of osteoarthritis. Fig. 7B shows that studies before 2017 focused on the expression of genes and pathway in synovial in osteoarthritis, research on the clinical effect of synovial in osteoarthritis was conducted between 2017 and 2019, and studies after 2019 focused on the influence of synovial in the treatment of osteoarthritis. The VOSviewer can use the frequencies of keywords to determine their density, as shown in Fig. 7C. We discovered that the density increases with color warmth (moving toward red). The area with a large gray level is typically where the research hotspot in this field were found. Using citespace for keyword outbreak analysis, we found that “human articular cartilage (n = 6.91)" had the largest keyword outbreak from 2013 to 2015, and “clinical trials” (n = 6.66) had the largest keyword outbreak from 2015 to 2019. The largest keyword outbreak in 2020–2022 was “exosome” (n = 6.66) (Fig. 7D).

Fig. 7.

Fig. 7

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Co-occurrence analysis of synovial in osteoarthritis studies from 2013 to 2022 based on WoSCC database. Fig. 7A. Mapping of key words of synovial in osteoarthritis studies. Fig. 7B. Mapping time distribution of synovial in osteoarthritis studies. Fig. 7C. According to the keyword distribution of average occurrence frequency, the red keyword represents the highest frequency. Fig. 7D. Top 20 keywords with the strongest citation bursts in synovial in osteoarthritis studies.

3.7. Analysis of cited articles

The top 10 citation articles on synovial in osteoarthritis studies from 2013 to 2022 are shown in the table below. The number of citations for the top 10 articles ranged from 915 to 400. Berenbaum, F. had the most articles cited (n = 915); Khandpur Ritika had 756 articles cited, ranking the second; Jeon Ok Hee had 600 articles cited ranking the third. Most of the citations were located in JCR Q1, demonstrating the high influence on synovial in osteoarthritis studies (Table 6).

Table 6.

Top 10 citations of synovial in osteoarthritis from 2013 to 2022.

Rank Title Total First author Year Journal
1 Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!) 915 Berenbaum, F. 2013 OSTEOARTHRITIS AND CARTILAGE
2 NETs Are a Source of Citrullinated Autoantigens and Stimulate Inflammatory Responses in Rheumatoid Arthritis 756 Khandpur, Ritika 2013 SCIENCE TRANSLATIONAL MEDICINE
3 Local clearance of senescent cells attenuates the development of post-traumatic osteoarthritis and creates a pro-regenerative environment 680 Jeon, Ok Hee 2017 NATURE MEDICINE
4 Low-grade inflammation as a key mediator of the pathogenesis of osteoarthritis 610 Robinson, William H. 2016 NATURE REVIEWS RHEUMATOLOGY
5 Inhibition of TGF-beta signaling in mesenchymal stem cells of subchondral bone attenuates osteoarthritis 582 Zhen, Gehua 2013 NATURE MEDICINE
6 Osteoarthritis: toward a comprehensive understanding of pathological mechanism 489 Chen, Di 2017 BONE RESEARCH
7 Defining inflammatory cell states in rheumatoid arthritis joint synovial tissues by integrating single-cell transcriptomics and mass cytometry 429 Zhang, Fan 2019 NATUREIMMUNOLOGY
8 MSC exosomes mediate cartilage repair by enhancing proliferation, attenuating apoptosis and modulating immune reactivity 416 Zhang, Shipin 2018 BIOMATERIALS
9 Damage-Associated Molecular Patterns in Inflammatory Diseases 407 Roh, Jong Seong 2018 IMMUNE NETWORK
10 Synovitis in osteoarthritis:current understanding with therapeutic implications 400 Mathiessen, Alexander 2017 ARTHRITIS RESEARCH&THERAPY
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3.8. Analysis of co-cited literature

The co-cited literature on the influence of synovial in osteoarthritis is shown in Fig. 8. A visual network of all references is displayed in Fig. 8A, including 971 nodes and 1813 links. Cited articles are represented as nodes, and the linkages among them show how frequently the same literature is cited. The node's diameter and reference frequency are proportional. Links between nodes indicate the size of references to the same article. Node diameters are proportional to the total number of articles that have been cited in one publication. Nodes can be used to link the progression of a domain, and a thick purple ring indicates centrality. A burst of references is indicated by the red ringThe co-cited literature was divided into 10 clusters, which were synovial mesenchymal stem cells, toll-like receptors, serum levels, biochemical markers, articular cartilage, induced osteoarthritis, hand osteoarthritis, anterior cruciate ligament injury, exosome, and macrophage polarization (Fig. 8B). According to the timeline view of co-citation clustering, we found that synovial substances and their expressions have become the hotspots related to synovial osteoarthritis (Fig. 8C). Finally, we analyzed the top 20 articles on the outbreak of citations of synovial for osteoarthritis, and found that most articles were located in JCR Q1, indicating that synovial was favored by scholars in high-level journals of osteoarthritis research (Fig. 8D).

Fig. 8.

Fig. 8

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A. Synovial in osteoarthritis research in recent 10 years. Fig. 8B. Cluster map of co-cited references of synovial in osteoarthritis studies in recent 10 years. Fig. 8C. Timeline of co-citations of synovial in osteoarthritis studies over the last 10 years. Fig. 8D. Top 20 literatures with the strongest citation burst of synovial in osteoarthritis research in recent 10 years.

3.9. Dual map

Fig. 9 shows the synovial studies in osteoarthritis was in the dual map. The research published in journals is displayed on the left side of the dual map, while the journals in which these published studies were cited are displayed on the right side. The lines connecting them indicate the relationships between the journals' citations. The line consists of two yellow lines and one green line. The research published in medicine is represented by the green line; research published in molecular biology and immunology is represented by the yellow line; immunology articles were cited by studies published in molecular, biology, genetics, and sports, rehabilitation, sport.

Fig. 9.

Fig. 9

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Synovial studies in osteoarthritis was in the dual map. The left side of the dual map shows studies published in journals and the right side shows the journals in which these published studies were cited.

4. Discussion

Osteoarthritis is the most prevalent type of arthritis and a major contributor to disability. Osteoarthritis is an age-related disease that has the highest incidence of bone and joint diseases worldwide, specifically osteoarthritis of the knee and hip, and is one of the primary causes of disability in the world [13]. It has a significant impact on individual well-being and increases the economic burden on society and individuals. Therefore, more research is needed to guide the prevention, diagnosis and treatment of OA [[14], [15], [16]]. Articular cartilage degeneration, marginal osteophyte formation, subchondral osteosclerosis, and synovial inflammation are pathological features of osteoarthritis. The influence of subchondral bone and cartilage on osteoarthritis was the primary focus of earlier research [17]. This paper conducted bibliometric analysis on the influence of synovial membrane on osteoarthritis.

The amount of research on the function of synovial membrane in osteoarthritis that has been published has increased over the past ten years, suggesting that synovial membrane's impact on the condition is growing. A total of 5738 articles on synovial in osteoarthritis have been published in the past 10 years. China has published the most articles, this may have something to do with population size and financial input. It is also worth noting that the majority of the top 20 active institutions carrying out this research are based in Europe and the US, which illustrates how well-equipped these countries are to carry out basic and clinical medical research due to a wealth of advanced equipment, specialized researchers, and sufficient funding. At the same time, it shows the urgent need for exploring the relationship between synovial and osteoarthritis in these countries. In most countries, the central value is less than 0.1, demonstrating that countries are not closely linked with researchers. In terms of institutions, Duke Univ published the most articles, China Med Univ ranked second, Univ Calgary third, Univ Med Ctr Utrecht fourth and Southern Med Univ fifth. The central value of most institutions is less than 0.1, indicating that researchers are not closely connected among different institutions. In terms of Tang, Chih-Hsin published 53 articles at most.

In terms of published journals, OSTEOARTHRITIS AND CARTILAGE ranked first, ARTHRITIS RESEARCH THERAPY ranked second, JOURNAL OF ORTHOPAEDIC RESEARCH ranked third, The majority of journals published in JCR Q1 illustrate the role of synovial in osteoarthritis and are welcomed by high level journals. The majority of published journals and active institutes are based in Europe and the US, suggesting that these regions have the financial and resources means to conduct extensive research on synovial in osteoarthritis. English is the world common language, which will make it easier for research towards the world and will be highly influenced by more researchers.

Finally, dual map shows that the studies involved in synovial in osteoarthritis published in medicine, medical, clinical articles were cited by studies published in molecular, biology, genetics, the studies published in molecular biology, immunology articles were cited by studies published in molecular, biology, genetics, and sports, rehabilitation, sport. Looking at the three main paths in the journal dual map, it is clear that the study of the relationship between synovial and osteoarthritis is a multidisciplinary endeavor. In terms of institutional sponsorship, the National Natural Science Foundation gave the most, but Europe and the United States gave the most.

Regarding keyword co-occurrence, research before 2017 focused on the expression of synovial in osteoarthritis, studies from 2017 to 2019 focused on the clinical effect of synovial on osteoarthritis, and studies after 2019 focused on the role of synovial in the treatment of osteoarthritis."human articular cartilage” had the largest keyword outbreak from 2013 to 2015, and “clinical trials” had the largest keyword outbreak from 2015 to 2019. The largest keyword outbreak in 2020–2022 was “exosome". In terms of citation, Berenbaum, F. had the most articles cited. Most of the citations were located in JCR Q1, demonstrating the high influence on synovial in osteoarthritis studies. In terms of co-cited literature, it was divided into 10 clusters, which were synovial mesenchymal stem cells, toll-like receptors, serum levels, biochemical markers, articular cartilage, induced osteoarthritis, hand osteoarthritis, anterior cruciate ligament injury, exosome, and macrophage polarization. According to the time line view of co-citation clustering, we found that synovial substances and their expressions have become the hotspots related to synovial osteoarthritis. Our keyword analysis revealed the expression of synovial genes and pathways in osteoarthritis, the role of synovial membranes in osteoarthritis diagnosiss, the influence of targeted synovial membranes in the treatment of osteoarthritis, the clinical effect of synovial membranes on osteoarthritis, and the role of synovial membranes in the pathology of osteoarthritis as five distinct clusters of synovial membranes in osteoarthritis.

Regarding the expression of synovial genes and pathways in osteoarthritis, Previous studies have shown that the increase of hypoxia-inducing factor 1 alpha, STC1, S100A8,S100A9, MMP-3, BMP-6, IL-6, IL-8, CXCL5, CXCL6, CXCL16, CXCL2 and CXCL1 genes in synovium contributes to the development of osteoarthritis [[18], [19], [20], [21]]. Changes in the expression level of pathways in synovial also affect the generation of osteoarthritis. For example, the activation of PI3k/Akt and NF-κB pathways can promote the generation of synovitis and induce osteoarthritis [22,23], and the activation of Wnt/β-catenin signaling pathway in synovial cells can promote the fibrosis of synovitis and thus promote the generation of osteoarthritis [24].

Regarding the role of synovial markers in the osteoarthritis diagnosis, many products are released through synovial membrane into synovial fluid and serum as synovial membrane. First, in a clinical study of OA patients with synovitis, it was found that excessive expression of matrix metalloproteinases promoted the cleavage of type I and III collagen into C1M and C3M collagenous degradation fragments in synovial cells and their release into human serum and synovial fluid [24]. The same study also indicated that increased C1M and C3M levels in vivo could be used as a reference index for OA joint synovial inflammation [25]. Secondly, the infiltration of macrophages and other inflammatory cells in synovium can promote the production of vascular endothelial growth factor and thus develop into OA [26]. Clinical studies in patients with osteoarthritis suggested that high expression of vascular endothelial growth factor promoted the development of osteoarthritis. Thirdly, elevated leptin expression in individuals with metabolic syndrome could enhance the interaction between chondrocytes and synovial fibroblasts, which may indirectly trigger the release of IL-6 by synovial fibroblasts in an IL-6-dependent manner [27]. The high expression of IL-6 has been confirmed in clinical studies as a basis for the diagnosis of osteoarthritis [28]. Similarly, high mobility group protein B1 is highly expressed in OA synovial cells, and promotes the high expression of inflammatory factors such as NF-kb and IL-6, which are released into human serum and synovial fluid to promote OA [29]. Lubricin is a glycoprotein secreted by synovial fibroblasts and found in synovial membrane and synovial fluid. It protects cartilage cells by reducing friction in the joints. Researchers found that reduced expression was associated with the development of osteoarthritis[30]. Finally, human cartilage glycoprotein-39 can be secreted by synovial cells and may be released in synovial fluid and serum leading to OA production [31].

The following are synovial's clinical effects on osteoarthritis: First, clinical research has shown a correlation between knee pain and synovitis in individuals with osteoarthritis of the hip and knee [32]. Researchers have looked into the connection between specific joint pathology identified by MRI in patients with osteoarthritis (OA) and knee pain. They made note of the connection between knee pain and synovitis. Also MRI showed the severity of the synovial, the increasing pain of hip OA. Therefore, contrast enhanced-MRI has shown that peri-patellar region are correlated with the severity of the knee pain. Secondly, clinical studies have also confirmed that synovial inflammation is associated with knee dysfunction [33]. The patient with knee OA showed the functional impairment and disability. Finally, synovitis is associated with cartilage loss that promotes osteoarthritis [34]. Researchers have shown that synovitis will predict the loss of cartilage in next 3 months, another researchers proved that the inflammation of synovial may predict cartilage defect in over next 3 years.

The therapeutic effect of targeted synovial on osteoarthritis can be reflected in the following four aspects. First, synovial mesenchymal stem cells can treat osteoarthritis. Synovial mesenchymal stem cells can be used as a source of chondrocytes for cartilage repair because they possess the trilineage potential to differentiate into fat, bone, or cartilage cells, as demonstrated by numerous studies. It has since been determined that SF-MSC transplantation to the afflicted joints, to restore the degraded chondrocytes and encourage regeneration, is a feasible cell therapy for OA. Exosomes derived from human synovial mesenchymal stem cells reduced the inflammatory process and apoptosis, degeneration, and degradation in chondrocytes caused by IL-1β. Exosomes secreted by synovial mesenchymal stem cells can effectively treat osteoarthritis by inhibiting synovitis [35]. In vitro, MSCs stimulated anti-inflammatory M2 polarization and prevented the activation of pro-inflammatory M1 macrophages. MSCs are linked to converting TNF-a and IL-1 inflammatory cytokines into immunosuppressive IL-10 production by macrophages, reducing joint inflammation and encouraging cartilage regeneration. Secondly, synovial M2-type macrophages have a therapeutic effect on osteoarthritis by inhibiting synovitis [36]. M2 macrophages participate significantly in tissue repair. The switch to M2 macrophages in the lesion may help heal the injured articular cartilage to treat OA. A type 1 to type 2 immune response, linked to M2 macrophages and the presence of IL-4 and IL-10 cytokines, may occur in the synovial microenvironment due to moderate physical activity, according to available data. Patients with OA may benefit from a protective environment in their joints thanks to these changes. It has been demonstrated that M2 macrophages aid in collagen turnover to maintain extracellular matrix homeostasis. Additionally, it has been demonstrated that M2 macrophages maintain extracellular matrix homeostasis by promoting collagen turnover. Furthermore, platelet-rich plasma has been shown to reduce synovitis thickness and treat osteoarthritis with synovitis [37]. Platelet-rich plasma can effectively improve pain and function and reduce adverse reactions. It has been documented that type B synoviocytes produce substantially high levels of hyaluronic acid following the addition of PRP during knee arthroplasty for osteoarthritis. Additionally, PRP stimulates synoviocytes to produce hepatocyte growth factor, which is known to reduce inflammation within the synovial membrane. Finally, many drugs can be used to treat osteoarthritis by targeting synovium, such as chondroitin sulfate, hyaluronic acid, baicalin, pirfenidone [38]. They can lower the inflammation cytokines in synovial fluid and decrease the inflammation of synovial in OA patients.

Regarding the role of synovial in osteoarthritis pathology, previous studies have pointed out that the aggregation of inflammatory cells and the expression of inflammatory mediators in synovium are important factors in the pathogenesis of osteoarthritis, and chronic inflammation of synovium can promote the generation and progression of osteoarthritis [39]. Synovial endothelial cell proliferation, moderate inflammatory cell infiltration and neovascularization were observed in patients with osteoarthritis, and the proliferative thickness of synovial tissue was significantly correlated with the degree of inflammatory cell infiltration [6].

5. Strength and defect

This study is the first to comprehensively, objectively and intuitively analyze the literature related to the influence of synovial on osteoarthritis and its development trend, which can offer a thorough reference for scholars working on this topic. Furthermore, we examine various facets of research hotspots using a range of bibliometric software, which enabled us to produce more precise and impartial results. The study inevitably has certain shortcomings. First, this study may not have covered all relevant literature., and other databases were not explored as the WoSCC database is a reliable, extensive, and varied database. Additionally, the study only included original research and reviews, and the language was limited to English to facilitate the interpretation of the results. This may have decreased the number of publications retrieved and led to some being missed. Another drawback of this study is that the bibliometric software was unable to differentiate between manuscripts using human and animal models. Lastly, there is a chance that some of the data's authors share the same name, and that some hold honorary positions or part-time jobs at various universities. Nevertheless, we think that this study effectively captures the present situation and overall direction of this field's research. This work provides a foundation for orthopaedic surgeons and related researchers to promptly identify areas of interest and new research directions in the impact of synovial on osteoarthritis.

Data availability statement

The original citation data used in this article were downloaded from Web of Science, an open public database at https://www.webofscience.com/.

CRediT authorship contribution statement

Guangtao Han: Conceptualization, Data curation, Project administration, Resources, Software. Lijun Cai: Data curation, Formal analysis. Bohua Li: Investigation. Qianhao Li: Formal analysis. Yue luo: Software, Supervision, Validation, Writing – original draft. Qiuru Wang: Writing – original draft, Writing – review & editing. Pengde Kang: Writing – review & editing.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgements

This work was supported by National Natural Science Foundation of China (No. 8217090607).

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