Modern Internet Search Analytics and Total Joint Arthroplasty: What Are Patients Asking and Reading Online?

Shen, Tony S.; Driscoll, Daniel A.; Islam, Wasif; Bovonratwet, Patawut; Haas, Steven B.; Su, Edwin P.

INTRODUCTION: Patients considering total joint arthroplasty often search for information online regarding surgery, however little is known about the specific topics that patients search for and the nature of the information provided. Google compiles frequently asked questions associated with a search term using machine learning and natural language processing. Links to individual websites are provided to answer each question. Analysis of this data may help improve understanding of patient concerns and inform more effective counseling. METHODS: Search terms were entered into Google for total hip and total knee arthroplasty. Frequently asked questions and associated websites were extracted to a database using customized software. Questions were categorized by topic; websites were categorized by type. JAMA Benchmark Criteria were used to assess website quality. Pearson’s chi-square and Student’s t-tests were performed as appropriate. RESULTS: A total of 620 questions (305 TKA, 315 THA) were extracted with 602 associated websites. The most popular question topics were Specific Activities (23.5%), Indications/Management (15.6%), and Restrictions (13.4%). Questions related to Pain were more common in the TKA group (23.0% vs 2.5%, p<0.001) compared to THA. The most common website types were Academic (31.1%), Commercial (29.2%), and Social Media (17.1%). JAMA scores (0-4) were highest for Government websites (mean 3.92, p=0.005). CONCLUSION: The most frequently asked questions on Google related to total joint arthroplasty are related to arthritis management, rehabilitation, and ability to perform specific tasks. A sizeable proportion of health information provided originate from non-academic, non-government sources (64.4%), with 17.1% from social media websites.