title: Integrating Social Media and Anterior Cruciate Ligament Surgery: An Analysis of Patient, Surgeon, and Hospital Use.
abstract: OBJECTIVE
  The purpose of this observational study of social media in sports medicine was to investigate and analyze the presence and shared content of anterior cruciate ligament (ACL) patients, sports surgeons, and top orthopaedic hospitals on popular social media streams.
  
  
  METHODS
  A search of 2 public domains (Instagram and Twitter) was performed over a 6-month period. ACL surgery ("#aclsurgery") was selected for the Instagram-based patient analysis after exclusion of veterinary ACL operations. A binary scoring system was used for media format, time (preoperatively or postoperatively), perioperative period (within 1 week of surgery), tone (positive or negative), return-to-work reference, return-to-play reference, rehabilitation reference, surgical-site reference, satisfaction reference, and dissatisfaction reference; perspective of the media was noted as well. A sample of 97 National Football League team surgeons was used for analysis of physician use in social media outlets and quantified by the number of posts. Hospital analysis categorized a sample of the top 50 orthopaedic hospitals by average number of posts and monthly posting rates with regard to orthopaedics, research, education, and personnel focus.
  
  
  RESULTS
  In the patient analysis, 3,145 public posts of human subjects were shared on Instagram. Of these, 92% were personal recovery stories, with an emphasis on postoperative photographs (93%) with a positive tone (88%) more than 1 week after surgery (73%). Posts focused on surgical site (25%), return to play (30%), and postoperative rehabilitation (37%). Of the physicians, 16% had Twitter accounts, with an average of 94 posts per surgeon; none had Instagram accounts. Of the hospitals, 96% had Twitter accounts and 32% had Instagram accounts. Most of the hospital-based Instagram content in the sample was centered on patients or celebrities.
  
  
  CONCLUSIONS
  Orthopaedic surgery has a large social media presence. Patients emphasize wound appearance, the rehabilitation process, and return to play. Ninety-six percent of hospitals are represented in social media outlets, whereas physicians are relatively under-represented.
  
  
  CONCLUSIONS
  Social media offers a unique window into what truly matters to patients after surgery and may help us better manage expectations, enhance health care delivery, and improve marketing strategies.
authors: Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio, U.S.A.. Electronic address: premramkumar@gmail.com.
authors: Prem N
authors: PN
authors: Ramkumar
authors: Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, Texas, U.S.A.
authors: Ton
authors: T
authors: La
authors: Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, Texas, U.S.A.
authors: Evan
authors: E
authors: Fisch
authors: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, U.S.A.
authors: Peter D
authors: PD
authors: Fabricant
authors: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, U.S.A.
authors: Alexander E
authors: AE
authors: White
authors: Department of Orthopaedic Surgery, University of California, Los Angeles, Los Angeles, California, U.S.A.
authors: Kristofer J
authors: KJ
authors: Jones
authors: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, U.S.A.
authors: Samuel A
authors: SA
authors: Taylor
mesh_terms: D059549:Anterior Cruciate Ligament Reconstruction; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D011639:Public Opinion; D000068958:Return to Sport; D061108:Social Media / Q000706:statistics & numerical data*; D013178:Sports Medicine