Accuracy of internet images of ligamentous knee injuries

ABSTRACT

Background: The internet is an easily accessible resource for both providers and patients. Despite this, the internet is not peer reviewed, leaving searches subject to inaccuracies, especially with regards to medical information. The purpose of this study was to review internet images of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL) tears using two popular search engines: Google and Bing.

Methods: A search query was performed on both Google and Bing for the following terms: ‘ACL tear’, ‘PCL tear’, ‘MCL tear’ and ‘LCL tear’. The first 100 images of each individual search were analyzed by three independent orthopedists.

Results: The inter-rater reliability was very good for PCL tear on Bing (Cronbach’s alpha = 0.89) and excellent (Cronbach’s alpha > 0.9) for the remainder of the search queries. When comparing Google to Bing, the only significant difference occurred in the ACL group, with Bing returning a significantly greater number of correct images 60%, 95% CI: 53.2 – 66.7%) compared to Google (45% correct, 95% CI: 38.1–51.8%), p = 0.034. With regards to the other ligaments Bing was more accurate than Google for PCL (39% versus 38%), and LCL (32% to 30%). Both sites were 48% accurate for MCL tear.

Conclusion: Ultimately, our study revealed that physicians should take an active role in making high quality, easy to understand medical resources and anatomic diagrams available to their patients to avoid confusion and enhance understanding when querying the internet for additional information regarding their condition.

KEYWORDS:

• Knee ligaments
• ACL
• patient education
• internet

Declaration of interest

B Owens is a consultant for Mitek and MTF/CONMED. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. A peer reviewer on this manuscript discloses educational support from: Smith and Nephew, Depuy/Mitek, Conmed Linvatec, Arthrex, Cook Myosite; and is on the publication board of: KSSTA, AJSM

Additional information

Funding

This manuscript was not funded.