YouTube Videos Lack Efficacy as a Patient Education Tool for Rehabilitation and Return to Play Following Medial Patellofemoral Ligament Reconstruction

Abstract

Purpose: To investigate the efficacy of YouTube videos as a patient education resource related to rehabilitation and return to play following medial patellofemoral ligament (MPFL) reconstruction. Methods: YouTube was queried using 6 predetermined search terms. Videos were included if they met the following criteria: (1) written in the English language; and (2) within the first 100 videos for each search term. Videos were excluded if they met any of the following criteria: (1) not written in the English language; (2) did not include medial patellofemoral ligament/MPFL in the title; (3) duplicate videos; (4) part of a multivideo series such a vlogs; (5) advertisements; and (6) videos <1 minute. The remaining videos were evaluated by 2 independent viewers and scored using 4 distinct scoring systems: Global Quality Scale, The Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT), MPFL Rehabilitation and Return to Play Score, and the Journal of the American Medical Association benchmark criteria. The data was analyzed with IBM SPSS Statistics, version 27). The Kruskal–Wallis test was used to compare quality scores and video analytics to their assigned categories. Results where P < .05 were considered statistically significant and pairwise comparison analysis was completed to determine the video categories with statistically significant differences. Correlation of categorical variables with video analytics (views, video power index, duration, and days since publication) and quality scores was determined using the Pearson Correlation coefficient. Results: Of the initial 600 videos, 58 met inclusion criteria, which were subsequently reviewed and scored. Most videos scored on the low-end of the possible scoring ranges with a mean Global Quality Scale score of 1.61 (standard deviation [SD] 0.81), PEMAT Understandability score of 59.40 (SD 17.54), PEMAT Actionability score of 18.20 (SD 29.92), MPFL Rehabilitation and Return to Play Score of 1.64 (SD 2.13), and Journal of the American Medical Association benchmark score of 2.08 (SD 0.75). Conclusions: The videos in YouTube’s library received low scores in quality, reliability, understandability and actionability. Therefore, YouTube is currently a poor source of information for patients regarding postoperative rehabilitation and return to play following MPFL reconstruction. Clinical Relevance: Patients increasingly view medical information online. YouTube is second only to Google as the most used search engine. It is important to understand the quality of information patients receive on YouTube following MPFL reconstruction so orthopaedic surgeons know to guide patients to higher-quality alternatives.