Abstract
Purpose
To evaluate the quality, reliability, and educational value of TikTok videos on cartilage surgery. It was hypothesized that overall quality would be low but higher in videos by healthcare professionals (HCP) and those with educational content.
Methods
TikTok was searched (September 22–25, 2025) using terms related to cartilage surgery and repair. Of 800 retrieved videos, 108 met inclusion criteria. Video metrics, uploader type, and content type were recorded. Quality and reliability were assessed using the DISCERN instrument, Journal of the American Medical Association (JAMA) benchmark criteria, and Global Quality Score (GQS). Associations between video metrics and quality scores were analyzed using Spearman rank correlation, and Mann–Whitney U tests compared scores by uploader and content type.
Results
Most videos were posted by private users (61.1%) and focused on patient experiences (58.3%). Duration, shares, and views correlated positively with all quality metrics (P < 0.001). HCP videos achieved significantly higher DISCERN (47.5 vs. 26.0), JAMA (2.9 vs. 0.9), and GQS (3.2 vs. 1.8) scores but lower engagement (all P < 0.001). Educational videos outperformed patient experience videos across all quality metrics (all P < 0.01).
Conclusion
TikTok videos on cartilage surgery demonstrated low overall quality and reliability. Greater professional engagement is needed to enhance the accuracy and credibility of cartilage-related information on social media.
Introduction
Cartilage lesions of the knee are a frequent cause of pain and functional impairment, particularly in young and active individuals.1 -4 Untreated chondral and osteochondral defects can lead to progressive joint degeneration and early osteoarthritis.5,6 Advances in surgical techniques, and their clinical success have increased the use of surgical management for symptomatic lesions.7 -10 However, these procedures are complex, require careful patient selection, and often lengthy rehabilitation.6,11 As a result, many patients seek additional information about their condition, treatment options, and recovery beyond traditional clinical encounters.
In recent years, social media (SM) has become a major source of health-related information, with survey showing that over half of orthopedic patients consult SM platforms for medical advice. 12 These platforms allow individuals, particularly those with limited access to specialized healthcare, to seek guidance and share experiences without direct physician contact. 13 Despite this potential benefit, only a small fraction of medical content is created by healthcare professionals (HCP).14 -17 Consequently, most online health information lacks scientific oversight, raising concerns regarding its accuracy, reliability, and educational value.15,18 -23
This issue is particularly relevant for TikTok (ByteDance Ltd., Beijing, China), a rapidly expanding platform where medical content is widely shared yet largely unregulated. 24 While the quality of orthopedic content on other platforms has been investigated in various subspecialities, TikTok, despite its immense popularity, has received comparatively little attention.25 -29 Moreover, no prior study has specifically evaluated content related to cartilage surgery, creating a notable gap given the complexity of these procedures. Given its high engagement among younger users, assessing the quality of information related to cartilage lesions and treatments is of particular importance, as these procedures are commonly performed in this demographic.30,31
The primary aim of this study was to evaluate the quality, reliability, and educational value of TikTok videos related to cartilage surgery, assessed using the DISCERN score, Journal of the American Medical Association (JAMA) benchmark score, and Global Quality Score (GQS). The hypothesis was that overall content quality would be low, but that videos created by HCP and those classified as educational content would demonstrate significantly higher quality and reliability scores.
Material and Methods
This was a cross-sectional analysis of publicly available TikTok content related to cartilage surgery. Because no human participants or identifiable personal data were involved, formal ethics approval was not required.
Search Strategy and Video Selection
TikTok (https//www.tiktok.com) was queried on September 22–25, 2025 to simulate a layperson’s approach to information-seeking, referring to a typical user or patient without medical training who searches the platform for health-related information. The following keywords were used in separate searches and combined iteratively: “cartilage surgery”; “cartilage repair”; “chondral defect”; “osteochondral defect”; “cartilage regeneration”; “cartilage transplant”; “OATS”; “osteochondral autograft”; “osteochondral allograft”; “autologous chondrocyte implantation”; “MACI”; “AMIC.” To minimize the influence of TikTok’s recommendation algorithm, all searches were performed on a new browser session without login credentials, ensuring no prior viewing history or personalization could shape the results.
A total of 800 videos were initially retrieved and screened for eligibility. For each search term, all scrollable video results were reviewed in full, to ensure that the complete set of publicly accessible content was screened. The initial screening was performed by 1 orthopedic surgeon, independently of the 2 orthopedic surgeons who subsequently conducted the quality assessments. Inclusion criteria were: (1) English language; (2) primary focus on human knee cartilage pathology or cartilage repair/reconstruction procedures; and (3) unique video (duplicates counted once). Videos were excluded if they were duplicates, non-English, unrelated to the topic, or videos lacking audio/visual information (e.g., music-only clips, unrelated footage, muted videos, or posts using medical hashtags without relevant information).
Data Collection and Video Classification
For each included video, the following were recorded in a standardized spreadsheet using Microsoft Excel (version 16.78, Microsoft Corporation, Redmond, WA):
Video metrics: duration (seconds), views, likes, and shares at the time of capture.
Source (uploader type): Private user (no professional credentials/affiliation in username, bio, or content), Physiotherapist/physical therapist (credentials such as “PT”, “Physiotherapist”, explicit clinic affiliation), Physician (medial degree, stated specialty, or institutional affiliation), Researcher/academic (university/lab affiliation or research-focused role without clinical credentialing).
Content type: Educational (anatomy/pathophysiology; indications/contraindications; peri-operative course; rehabilitation/physical therapy; surgical technique/explanation), or Personal experience (patient journey, vlog/testimonial, complication or outcome story without structured educational framing).
When videos covered multiple categories, the dominant theme defined the classification.
Quality, Reliability, and Educational Value Assessment
Two independent orthopedic surgeons evaluated all videos using three validated instruments widely applied in online health content research:15,20,22,32 -36
DISCERN questionnaire: The DISCERN instrument (https://www.discern.org.uk) is a 16-item instrument to evaluate the reliability and quality of written health-related information.16,34,37 The first eight items assess the reliability of the source, items 9–15 address the quality and completeness of treatment-related information, and item 16 provides an overall quality rating. Each of the first 15 items is rated on a 5‑point scale (1 = inadequate, 5 = fully adequate), yielding a total score between 15 and 75. Item 16 functions as a global assessment of overall quality, ranging from 1 (very poor) to 5 (excellent). According to established interpretation thresholds, total scores of 15–27 indicate very poor, 28–38 poor, 39–50 medium, 51–62 good, and 63–75 excellent quality.15,22
JAMA benchmark criteria: The JAMA benchmark criteria assess the reliability of online medical information across four domains: authorship, attribution, disclosure, and currency, scoring 0 to 4.33,38 Each criterion is assigned one point if fulfilled, resulting in a total score from 0 to 4. Higher scores reflect greater transparency and reliability, with 0–1 indicating insufficient information, 2–3 representing partial adequacy, and 4 denoting full compliance with all quality standards. 38
Global Quality Score (GQS): The GQS provides an overall assessment of the educational quality and usefulness of online videos. It is based on a 5-point scale, where a score of 1 denotes poor quality and limited usefulness, and a score of 5 represents excellent educational value and high overall quality. 32
Statistics
All extracted data were organized in Microsoft Excel (version 16.78, Microsoft Corporation, Redmond, WA) and analyzed using IBM SPSS Statistics (version 28.0, IBM Corp., Armonk, NY). Descriptive statistics were reported as mean ± standard deviation and range. The Shapiro-Wilk test assessed normality, and Levene’s test evaluated homogeneity of variances.
Spearman rank correlation was applied to examine associations between video characteristics and the DISCERN, JAMA, and GQS scores, with correlation coefficients (r) and P values reported. A correlation coefficient (r) of 0–0.19 was considered very weak, 0.20–0.39 weak, 0.40–0.59 moderate, 0.60–0.79 strong, and 0.80–1.0 very strong. 39 Differences in scores by video source and type of content were assessed with the Mann–Whitney U test. Due to small subgroup sizes, physiotherapists/physical therapists, physicians, and researchers were grouped as “healthcare professionals.” All tests were two-tailed, and P < 0.05 was considered statistically significant. For Mann–Whitney U tests, the U statistic, z-score, and P value are reported. Bonferroni correction was applied for multiple comparisons.
Results
A total of 108 TiKTok videos were included (
Flow chart of video-selection process.
The mean video duration was 51.61 ± 66.09 seconds (range, 6–366 seconds). Videos received a mean of 1,989.26 ± 13,086.90 likes (range, 4–134,930), 120.56 ± 504.38 shares (range, 0–4,019), and 123,994.05 ± 1,057,739.96 views (range, 98–11,000,000).
The mean DISCERN score was 34.36 ± 19.12 (range, 11–64), corresponding to poor quality. The mean JAMA benchmark score was 1.64 ± 1.50 (range, 0–4), indicating insufficient reliability, and the mean GQS was 2.38 ± 1.21 (range, 1–5), reflecting low educational value.
Video duration, number of shares, and views showed significant positive correlations with all quality metrics (all P < 0.001), while the number of likes correlated only weakly with DISCERN and GQS (P < 0.05) but not with JAMA. Strong positive intercorrelations were observed among DISCERN, GQS, and JAMA scores (all P < 0.001) (
Correlation Analysis Between Video Metrics and Quality Scores.
DISCERN = DISCERN questionnaire; JAMA = the Journal of the American Medical Association benchmark criteria; GQS = Global Quality Score.
Spearman rank correlation.
Statistical significance (P < .05).
Videos by HCP had significantly longer duration but lower engagement metrics than those uploaded by private users, with markedly fewer views, likes, and shares (all P < .001) (
Differences in Video Quality Scores by Uploader Type.
Values are presented as mean ± SD. DISCERN = DISCERN questionnaire; JAMA = the Journal of the American Medical Association benchmark criteria; GQS = Global Quality Score.
Statistical significance (P < 0.05).
Videos categorized as educational content had significantly longer duration and higher engagement metrics, with greater numbers of views, likes, and shares compared to patient experience videos (P < 0.01 for duration and likes; other: P < 0.001) (
Differences in Video Quality Scores by Content Type.
Values are presented as mean ± SD. Bonferroni’s correction applied. DISCERN = DISCERN questionnaire; JAMA = the Journal of the American Medical Association benchmark criteria; GQS = Global Quality Score.
Statistical significance (P < .05).
Discussion
The key finding of this study was that TikTok content related to cartilage surgery demonstrated overall low quality, limited reliability, and poor educational value. The mean DISCERN score was 34.4 ± 19.1, indicating poor quality; the mean JAMA score was 1.6 ± 1.5, reflecting insufficient reliability; and the mean GQS was 2.4 ± 1.2, denoting low educational value. These results confirm the study hypothesis that most TikTok content on cartilage surgery lacks high-quality, evidence-based information. Although videos produced by HCP achieved significantly higher quality scores across all three metrics, they represented less than half of all videos. Yet, the absolute scores of HCP videos remained in the moderate or partially adequate range rather than reaching high-quality thresholds, indicating that even more professionally produced content is not yet sufficient for reliable patient education. Educational content similarly scored higher than patient experience videos, reflecting that videos providing more comprehensive and informative content achieve better quality ratings. However, videos created by HCP were significantly longer but received markedly fewer views, likes, and shares than those from private users, suggesting that while professional content is more informative, it may be less appealing to the general audience. This pattern reflects a broader challenge in digital health communication: high-quality educational material often struggles to capture engagement in attention-driven platforms like TikTok. The considerable engagement observed overall, in terms of views, likes, and shares, underscores a strong public interest in cartilage surgery, yet this interest contrasts sharply with the limited availability of accurate, evidence-based information.
Cartilage procedures are increasingly performed in young and active patients who frequently turn to SM for medical information. 6 Given the complexity of these interventions, the need for shared decision-making, and the critical importance of adherence to postoperative rehabilitation, access to reliable online information is clinically relevant. Poor-quality or misleading content may shape unrealistic expectations, misinform patients about surgical options, or influence non-evidence-based decisions, potentially undermining trust in medical professionals.40 -42 Thus, understanding the quality of cartilage-related content on TikTok has direct implications for clinical practice and patient education. For clinicians, this is particularly pertinent because patient discussions in practice may be shaped by online content that requires correction or contextualization. 43 These findings highlight an urgent need for HCP to take an active role in shaping the digital information environment by producing evidence-based content, curating or commenting on existing posts, and linking to credible, peer-reviewed sources. Professional organizations, academic journals, and orthopedic societies should likewise support initiatives that promote the dissemination of trustworthy, high-quality content. Implementing mechanisms such as “fact-check” or “verified medical information” label, similar to systems already introduced on other platforms such as YouTube (Google LLC, Mountain View, CA), could enhance transparency, improve user trust, and ensure that patients receive accurate, science-based information.
Our results align closely with prior research evaluating orthopedic content on TikTok. However, to our knowledge, no previous study has specifically examined videos related to cartilage surgery. Studies on various orthopedic topics have consistently reported low overall quality and educational value of online videos.15,22,24,35,36,44 For instance, analyses of anterior cruciate ligament-related videos showed that despite high engagement, most content originated from non-professionals and provided poor or incomplete information. 44 Similarly, TikTok videos on total knee arthroplasty rehabilitation and knee osteoarthritis were found to lack scientific accuracy and evidence-based recommendations, even when produced by medical professionals.35,36 Comparable findings have been reported across other musculoskeletal conditions, including scoliosis, shoulder instability, and hip fractures, reinforcing the trend that SM engagement does not correlate with educational quality.45 -49
Interestingly, in our study, video duration and engagement metrics such as shares and views correlated positively with quality scores. This suggests that longer, more detailed videos may better convey educational information and attract viewer interaction. Similar correlations were reported by D’Ambrosi and Hewett, 22 emphasizing that short-form platforms like TikTok can still facilitate the dissemination of meaningful educational content when structured appropriately. Nonetheless, the brevity and entertainment-focused nature of TikTok make it inherently difficult to deliver comprehensive, evidence-based medical information. Algorithmic promotion of engaging but sensational content further compounds this issue, as emotionally charged or visually striking videos are prioritized over accurate, evidence-based material. This dynamic facilitates the rapid spread of misinformation, which can mislead patients regarding treatment options, outcomes, and rehabilitation expectations.50,51
Improving the accuracy and reliability of orthopedic information on SM requires active participation from HCP. Orthopedic surgeons and allied specialists should be encouraged to produce high-quality, accessible videos that address common patient questions regarding cartilage injury mechanisms, available treatment options, rehabilitation milestones, and postoperative expectations. Correcting misinformation through comments, collaborations, and links to credible sources could further enhance the informational environment. Moreover, professional societies and journals could promote SM literacy initiatives and provide verified educational content designed for platforms like TikTok.
Given the growing role of SM in patient education, clinicians should also engage patients in discussions about evaluating online sources critically. Given the well-documented gaps in digital health literacy among both patients and physicians, it is essential to address these deficits systematically.40,52,53 Integrating digital health communication into medical education and residency curricula could equip future clinicians with the skills to effectively communicate medical knowledge through short-form video content. 54 Such initiatives would not only improve the accuracy of publicly available health information but also strengthen the patient-clinical relationship in the digital era. Ultimately, leveraging SM as a tool for effective knowledge translation can bridge the gap between scientific evidence and public understanding, ensuring that research findings and best practices reach and benefit a broader audience. 55
Limitations
This study has several limitations. First, it analyzed only TikTok videos, and findings may not generalize to other SM platforms with different formats, algorithms, or audiences. TikTok was chosen because it is the fastest-growing platform and represents the current trend toward short, fast-paced, and engagement- driven video content, which is increasingly shared across other platforms. Second, video inclusion was limited to English-language content, which may not reflect information available to non-English-speaking users. Third, TikTok’s search algorithm and trending dynamics can introduce selection bias, and results represent a snapshot in time rather than an evolving landscape. Fourth, we focused on a specific topic to simulate typical user behavior, as TikTok is the primary platform used by the young, active demographic most likely to seek information on cartilage injuries and their treatment. While this limits the breadth of our analysis, our findings are consistent with prior observations in both orthopedic and non-orthopedic SM research. In addition, the search was performed by a single author at one time point, which may limit reproducibility and does not capture temporal fluctuations in TikTok content or algorithm-driven variation. Finally, although validated scoring tools (DISCERN, JAMA, GQS) were used, content evaluation remains partly subjective despite efforts to standardize assessment through independent reviewers.
Conclusion
TikTok videos related to cartilage surgery demonstrated low quality, limited reliability, and poor educational value, with most videos produced by private users (61.1%). Although videos created by HCP and those with educational content achieved significantly higher DISCERN, JAMA, and GQS scores, the overall standard remains insufficient for evidence-based patient education. Given the growing influence of SM on patient knowledge and decision-making, orthopedic specialists, and professional societies have both a responsibility and an opportunity actively contribute accurate, accessible, and engaging digital content to ensure the dissemination of trustworthy medical information.
Footnotes
Ethical Considerations
This study involved analysis of publicly available social media content and did not include human participants or identifiable personal data; therefore, formal ethics approval was not required
Author Contributions
Funding
The authors received no financial support for the research, authorship, and/or publication of this article.
Declaration of Conflicting Interests
The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Alan Getgood is a Consultant for Smith and Nephew and has stock ownership in Personalized Surgery and Kyniska Robotics.
Data availability statement
The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.