Analysis of the Perception and Treatment of Osteoarthritis of the Knee Through Social Media: An Observational Study of the Top 100 Viral TikTok Videos

Background: TikTok is a popular platform that can be used for medical insights. However, spreading inaccurate information about diagnosing or treating medical conditions can undermine the quality of patient care. Our assessment focused on the discourse surrounding knee osteoarthritis on TikTok, with two primary objectives: 1) identifying the creators behind osteoarthritis-related content, and 2) examining whether a connection exists between the reach of video content and the strength of recommendations provided. Methods: The top 100 TikTok videos were chosen based on likes on March 29, 2023. Posts were identified using the hashtag (“#Osteoarthritis”). Videos were classified by the following: number of likes, comments, shares, date of upload, uploader (medical professional, non-medical professional, or business), and video content (medical treatment, home remedy, personal story). Treatments were rated according to the American Academy of Orthopaedic Surgeons (AAOS) Evidence-Based Clinical Practice Guideline for Osteoarthritis using the strength of evidence criteria (1-4 stars). Descriptive and univariate analyses were performed. Results: Among the top videos, 67.7% were uploaded by medical professionals. Private companies, despite having the highest average likes (29,681.2) and shares (1,367.5) per video, had a limited average evidence strength of 2.13. Physician-created videos had the second-highest average number of likes (25,440.1) and shares (1,224.5) per video with a strength of evidence of 3.03. Non-medical professional videos had the lowest evidence support (0.89). Medical treatments, the most liked and shared content, had the lowest evidence strength (1). There was no statistically significant correlation between the number of likes (p=0.808), comments (p=0.647), or shares (p=0.439) to the strength of evidence regarding the intervention. Discussion: TikTok can be unreliable for knee osteoarthritis treatment information. It is common to find non-physicians sharing medical advice on the platform, with medical treatments demonstrating the weakest level of supporting evidence. Orthopaedic surgeons should advise their patients that TikTok treatment recommendations may not align with established guidelines.