Internet Promotion of Orthobiologics by the American Association of Hip and Knee Surgeons Members: Claims Versus Evidence in Patient-Facing Websites.

Abstract

Orthobiologic therapies such as platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and hyaluronic acid (HA) are increasingly offered for orthopaedic conditions, but their online promotion may not accurately reflect the often-mixed clinical evidence. This study examined the extent and nature of orthobiologics' promotion on surgeon websites and compared the claims to current peer-reviewed evidence. We performed a cross-sectional content analysis of websites for members of the American Association of Hip and Knee Surgeons (AAHKS) across North America. We used a standardized questionnaire to screen surgeon-associated websites that contained sufficient information for complete evaluation. There were 4,683 qualified websites associated with AAHKS members identified. Each of these websites was then evaluated for mentions of orthobiologics services, claims of benefits, and discussion of risks. A literature review of clinical studies on orthobiologics in joint preservation was conducted to compare online claims with scientific evidence. Orthobiologic therapies were referenced on 12.3% (n = 575) of these websites. The most mentioned orthobiologic was PRP, found on over half of the websites that discussed orthobiologics, followed by HA (viscosupplementation) and stem cell-based injections. Claims regarding orthobiologic-specific benefits included reduced pain (5.5%), accelerated healing (4.0%), and decreased inflammation (3.0%). Potential orthobiologic-related risks, such as injection site pain, injection site infection, and immune reaction, appeared on 2.6, 1.8, and 1.1% of websites, respectively. Orthobiologic injections were mentioned on 12.3% (575 of 4,683) of AAHKS member websites. Among these, benefit claims such as reduced pain (5.5%), accelerated healing (4.0%), and decreased inflammation (3.0%) appeared more often than risk disclosures (injection site pain, 2.6; injection site infection, 1.8; immune reaction, 1.1%). Uncertain efficacy or lack of long-term data was acknowledged on 7.5% (43 of 575) of orthobiologic-promoting sites. Orthopaedic professionals and societies should consider strategies to ensure accurate, balanced online education regarding novel therapies.