Is OA the way? A comparison of different open access classifications and their benefits in orthopaedic research

AbstractBackground: Open access (OA) publishing has reshaped scientific dissemination by improving accessibility, yet its impact on research visibility varies across OA models. In orthopaedic surgery, where evidence rapidly evolves, understanding the relationship between OA type and citation performance is essential.Objective: To assess the citation impact of different OA classifications (Gold, Green, Bronze, and Closed Access) in leading orthopaedic surgery journals, while accounting for authorship patterns, journal prestige, and publication year.Methods: We extracted article-level metadata (n = 24,183) from 10 high-impact orthopaedic journals published between 2014 and 2019. OA designations and citation counts were obtained from Web of Science. A negative binomial generalized linear mixed model evaluated the effect of OA type on citation counts, adjusting for author count, Article Influence Score (AIS), and publication year.Results: Gold OA articles received 2.98 times more citations than Bronze OA (95% CI: 2.71–3.27), while Green OA and Closed Access received 2.26 (95% CI: 2.10–2.43) and 1.89 (95% CI: 1.78–2.01) times more, respectively. Gold OA consistently outperformed other models across all years and author counts. Increased collaboration (author count) and higher journal AIS were also independently associated with greater citation impact. Bronze OA articles received the fewest citations and experienced the steepest citation decline over time.Conclusion: Not all OA models confer equal benefits. Gold OA demonstrates the strongest citation advantage, followed by Green and Closed Access, while Bronze OA underperforms despite being freely accessible. These findings inform orthopaedic researchers about the tangible impact of OA model selection on research dissemination and visibility.