Instructions for Reviewers


Comprehensive, high-quality, blinded peer review is essential to maintain an adequate publication standard.

Peer reviewers are orthopaedic surgeons or physicians from other disciplines who possess special expertise and who have demonstrated their willingness to perform timely and thorough manuscript reviews for the journal. Guest reviewers are invited if unique experience or knowledge is required on a specific topic.

Reviewers are asked to follow the structure and guidelines described below.

A methodological review is conducted for papers that have received a favourable content review and are being considered for publication.

Please also see our peer review policy

General guidelines

When you receive the invitation to review please consider the following question:

  • Do you have time to complete the review before the deadline?
  • Are you familiar enough with the content area and/or methods to provide a high-quality review?
  • Do you have any potential conflicts of interest?
  • If you are unable to review for any of these reasons please reply promptly to the invitation email in order to for another reviewer to be appointed.

Please attempt to complete your review within the provided deadline. If you will not be able to complete your review in time, please contact the Editorial Office at

A well-organised, detailed, thoughtful review will often be passed on to the authors.

Make your review as objective and evidence-based as possible. Perform a literature search on the topic in order to familiarise yourself with the current literature on the topic (OVID, Google Scholar and Pubmed, at least).

Your review can be as critical as you judge necessary. Always provide constructive criticism. Your comments should be helpful to the author(s) and should never be demeaning or pejorativeThe authors are likely to have put a huge amount of time and energy into their work. Disparaging comments are not helpful.

Do not spend a lot of time correcting language, grammar or spelling. If errors in these areas interfere with the overall message, make a general comment to this effect. If a specific error confuses a point, make a specific comment.

Please keep the content of the manuscript confidential.

Please avoid including a signature or any other ways of identifying you as a reviewer.

If you have any concerns please contact the section editor directly.

Follow a systematic procedure to review the manuscript and to write your review (see below).

Structure of review

Recommendations following review

  • Reject (resubmission not recommended)
  • Reject and resubmit
  • Major revision required
  • Accepted with minor revision
  • Accepted as is


Summarise the article in a short paragraph. The aim is to demonstrate your understanding of what the work is about.

Briefly state your understanding of the research question and methodology.

General comments

  • Please provide a paragraph for this to put the study in the context of previously reported information.
  • Is it relevant to clinical practice in South Africa?
  • Is the relevance to the South African orthopaedic surgeon discussed?

Specific comments

  • Title
  • Abstract
  • Level of evidence
  • Introduction
  • Methods
  • Results
  • Discussion
  • Conclusion
  • References
  • Illustrations
  • Tables
  • Organisation
  • Language, punctuation, grammar and spelling

Further requirements:

  • Was the research question clearly elucidated in the introductory section?
  • Was sufficient detail provided in the methods section so that another researcher can replicate the study?
  • Was the statistical methodology employed sound?
  • Were subject recruitment procedures, and inclusion and exclusion criteria accurately described?
  • Was the follow-up period adequate?
  • Were the limitations of the study adequately explored?
  • Was the conclusion supported by the data presented in the study?
  • Were all necessary references provided?
  • Was the necessary ethical standard maintained?
  • Does the article satisfy the requirements set out in the Instructions for authors section?

Note: If the answer to any of these questions is no, the paper should either be rejected, rejected and resubmitted, or returned to the authors for major revision.

Specific comments

This part of the review should consist of a detailed listing of your specific concerns with the manuscript. Each item in the list should refer to a specific location in the text (including the page, paragraph and line numbers). Your specific, precise comments will be valuable to the authors when they revise their work. Constructive criticism will be appreciated. In addition to the text, the following elements of the manuscript should be assessed.


  • Does it clearly describe the subject of the paper?


  • Is it an accurate, succinct reflection of the aims, methods, results and conclusion?

Level of evidence

  • Is the proposed level of evidence appropriate?
  • Please follow the level of evidence guidelines provided by the Oxford Centre for Evidence-Based Medicine (OCEBM); version 2.1.
  • Available from: OCEBM Levels of Evidence Working Group. ‘The Oxford Levels of Evidence 2’. Oxford Centre for Evidence-Based Medicine.


  • Is it an unbiased introduction to the topic?
  • Is an adequate background given?
  • Does it mention the relevance of the research question?
  • Do the authors give a research question or hypothesis?
  • Are the aims and objectives communicated clearly?


  • Was the methodology employed appropriate for the research question that was posed?
  • Could the study be replicated with the details given?
  • Was the sampling described?
  • Are the inclusion and exclusion criteria adequate?
  • Is the statistical analysis sufficiently and correctly described and is it appropriate?


  • Do the results address the research questions?
  • Are there unnecessary duplications (i.e. results in text also shown in tables?)
  • Are the results described logically and in a clear fashion?


  • Is a logical and meaningful interpretation of the results made?
  • Is the interpretation of the results within the boundaries of the study limitations?
  • Are the results brought into context with current knowledge and evidence?
  • Has it been done in a balanced manner?
  • Did the authors describe the implications of the findings?
  • Is there a statement made regarding the generalisability of the findings?
  • Are limitations given adequately?


  • Is there a clear and logical summary of the findings?
  • Is the conclusion scientifically valid in terms of the results that were presented?
  • Do the authors give suggestions for future research?
  • Is a take-home message given?


  • Is the bibliography adequate and was all relevant literature discussed (without being excessive)?
  • Have all the important statements been referenced?


  • Do illustrations support the main point of the article?
  • Are all the illustrations appropriate and necessary? If not, which ones would you delete?
  • Are the legends adequate?


  • Are all the tables necessary, or could several tables be combined?
  • Are clarifications or additional columns needed?
  • Please suggest changes if you believe that they would help the author to present the information more clearly.


  • Is the organisation of the manuscript satisfactory?
  • Does the text provide the reader with all the information that is needed in each section?

Language, punctuation, grammar and spelling

  • Is this of an acceptable standard?

Decision categories

Reject and resubmission not recommended

This means that the paper is considered inadequate for publication in the journal, either because the quality is too poor, or because the paper is out of scope for the journal, or because of ethical problems (duplicate submission, self-plagiarism or plagiarism). List two or three major reasons why you believe the manuscript should be rejected. If you are recommending a rejection of the manuscript it is neither necessary nor desirable to complete a comprehensive specific comments section as these are intended to help the authors who are invited to revise their submission.

Reject and resubmit:

This is relevant in the following situations:

  • The submission is incomplete.
  • The submission fails to comply with the Instructions for authors guidelines.
  • The content of the paper could potentially be of interest but the paper has too many deficits to expect that it will be of sufficient quality to allow publication following major revision. Compared to a simple ‘reject’ decision, this is a signal to the authors that they may have an interesting idea but that they need to write a new paper and not to try to enhance the existing one.

Major revision

This implies that in its present state the paper is below standard for publication and requires substantial revision. However, the reviewer believes that the authors can correct these deficiencies. Reasons may include lack of putting the work into perspective, lack of sufficient experimental validation, or serious flaws in the way the work is presented or justified, etc. A major revision decision is in no way a commitment to ultimately accept a revised version of the paper for publication. If the revised version of a paper has not addressed the initial concerns and still raises major concerns after major revision, it is probably better to reject it than to extend the reviewing process.

Accept with minor revisions

This means that the major aspects of the paper are considered to be of sufficient quality for publication. This is actually a commitment to ultimately publish the paper, provided that the authors adequately answer the remaining concerns (which should be relatively minor) and correct the relevant language/grammar/spelling problems.

Accept as is

Article is suitable for publication as is, without further revision or corrections. This decision is not typically used following the first review but frequently applied to papers after minor/major revision.