YouTube provides poor information regarding anterior cruciate ligament injury and reconstruction.
OBJECTIVE
YouTube is a global medium used predominantly by young adults (aged 18-49 years). This study examined the quality of YouTube information regarding ACL injury and reconstruction.


METHODS
YouTube was searched on the 13th of June 2015 for "ACL" and "anterior cruciate ligament" with/without associated terms of "injury", "reconstruction", and "surgery". Videos were evaluated by two independent reviewers [EF (Reviewer 1), (Reviewer 2)] using two recognized information scoring systems (Modified DISCERN (MD) 0-5 and JAMA Benchmark 0-4) and an adaptation of a score designed for written ACL information [ACL Specific Score (ASS) 0-25]. The ASS categorized scores as very good (21-25), good (16-20), moderate (11-15), poor (6-10), and very poor (0-5). Number of views/likes/dislikes, animation, and continent of origin and source (e.g., corporate/educational) were recorded. Correlation of video characteristics with number of views was examined using the analysis of variance (ANOVA) model. Agreement between reviewers was assessed by Interclass Correlation Co-efficient (ICC).


RESULTS
Following a filtering process of the 964,770 identified videos, 39 videos were retained. The mean MD score was 2.3 (standard deviation (SD) ±0.9) for Reviewer 1 and 2.2 (SD ±0.9) for Reviewer 2 (ICC = 0.7). The mean JAMA score was 2.5(SD ±0.7) for Reviewer 1 and 2.3 (SD ±0.7) for Reviewer 2 (ICC = 0.8). The mean ASS was 6.3 (SD ±3.5) for Reviewer 1 and 4.6 (SD ±2.9) for Reviewer 2 (ICC = 0.9). Five videos achieved moderate score (13%), while 15 (38%) and 19 (49%) scored as poor and very poor, respectively. There was no correlation between number of views and video quality/video source for any scoring system.


CONCLUSIONS
The majority of videos viewed on YouTube regarding ACL injury and treatment are of low quality.
Department of Orthopaedics, University Hospital Limerick, Limerick, Ireland. tristancassidy@gmail.com.
J T
JT
Cassidy
Department of Orthopaedics, University Hospital Waterford, Ardkeen, Waterford, Ireland.
E
E
Fitzgerald
Faculty of Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
E S
ES
Cassidy
Department of Orthopaedics, University Hospital Waterford, Ardkeen, Waterford, Ireland.
M
M
Cleary
Sports Surgery Clinic, Santry, Dublin, Ireland.
D P
DP
Byrne
OrthoSport Victoria, Richmond, VIC, Australia.
B M
BM
Devitt
Waikato Hospital, Hamilton, New Zealand.
J F
JF
Baker
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D005260:Female; D006801:Humans; D033181:Information Dissemination / Q000379:methods*; D008297:Male; D010353:Patient Education as Topic; D015203:Reproducibility of Results; D061108:Social Media; D016896:Treatment Outcome; D014741:Video Recording; D055815:Young Adult
Anterior cruciate ligament/ACL; Decision analysis; Knee; YouTube