ACL injury prevention content on TikTok: Untapped outreach potential for youth athletes.

Abstract

To evaluate the overall quality and extent of viewership of primary anterior cruciate ligament (ACL) injury prevention content on TikTok. The social media platform TikTok was queried using ACL injury prevention terms, and the 89 most-viewed English-language videos demonstrating primary preventative ACL injury exercises were included. This sample size was determined a priori via power analysis to detect a moderate effect. Two authors independently extracted video characteristics and engagement metrics and scored content quality using DISCERN, Principles for Health-related Information on Social Media (PRHISM) and ACL Exercise Education Score (ACLEES) scoring systems. Disputes were resolved via author consensus. Interrater reliability was assessed using Cohen's κ. Statistical analyses included linear regression, t-tests and Fisher's exact tests. Collectively, the included posts garnered 5,988,018 views, 569,486 likes and 28,385 shares. Median scores were 30 (interquartile range [IQR] 24-38) for DISCERN, 13 (IQR 10-16) for PRHISM and 10 (IQR 6-15) for ACLEES, all indicating poor overall quality. Domain analysis revealed that content was generally accessible and relevant yet lacked citation of evidence and follow-up information. Post length significantly correlated with all three scoring systems. Self-identified healthcare professionals achieved significantly higher PRHISM scores than general users in authorship, authority and financial disclosure domains. No differences were found in engagement metrics or in DISCERN and ACLEES scores between the two groups. Primary ACL injury prevention content on TikTok is widely viewed, accessible and relevant, but generally of poor quality among both healthcare professionals and general users. Both post author groups inadequately provided condition-specific guidance, treatment rationale and references. TikTok may represent an important avenue for orthopaedic professionals to establish a presence and disseminate high-quality, evidence-based information regarding ACL injury prevention to youth and adolescent athletes in hopes of decreasing injury rates. N/A.