Instagram and Spine Fusion: An Analysis of Social Media and Its Relationship to Patient Perception of Surgery

Patient Perception of Social Media Use by Orthopaedic Surgeons: A Pilot Study

Background

Social media (SM) use by orthopaedic surgeons is becoming increasingly common; nonetheless, it needs to be clarified how patients perceive the content posted by physicians.

Purpose

To characterize SM content posted by orthopaedic surgeons while investigating patient perceptions of this content and how it may influence their health care decisions.

Study Design

Cross-sectional study.

Methods

Posts on SM outlets by orthopaedic surgeons were reviewed and categorized. A survey to assess patient perception of these categories was administered between December 2021 and February 2022 in the clinics of 3 orthopaedic surgeons. Survey results were analyzed for differences in patient SM use and perception of SM content types.

Results

There were 250 completed surveys. SM use was high among all age groups; however, the 18 to 24 years (87.1%) and 25 to 34 years (86.4%) age groups were more likely than older age groups to report daily use (P = .002). Overall, 17% of patients reported using SM to see information about their health care at least once per month, 21% reported reviewing the SM account of a physician at least once per month, 19% reported that they were likely or very likely to view the SM account of their physician, and 23% reported that SM content was likely or very likely to influence which physician they see. Patients held the most consistently positive view of posts that educated patients, discussed sports team coverage, and provided patient testimonials. Patients had consistently neutral views of posts educating colleagues, discussing presentations at national meetings, displaying aspects of surgeons' personal lives, and supporting marginalized groups. Several post categories elicited highly polarized responses-including those discussing research publications and showing surgical techniques or pictures/videos taken during surgery. Respondents had a consistently negative response to posts making political statements.

Conclusion

SM is likely a useful tool to help physicians interact with patients. Physicians who wish to interact with patients should consider posting content viewed most positively-including posts educating patients, discussing sports team coverage, and providing patient testimonials. Content that is viewed less favorably should be posted sparingly or with a sensitive tag.

Social Media Posts About Carpal Tunnel Release: A Cross-Sectional Analysis of Patient and Surgeon Perspectives

BACKGROUND

Social media provides an increasingly popular, unfiltered source of perspectives on healthcare. The objective of this study is to characterize the landscape of social media posts regarding carpal tunnel release (CTR).

METHODS

Content was queried from Instagram between February 2, 2019 to August 12, 2021 using the hashtags #carpaltunnelrelease and #carpaltunnelsurgery. The 1500 most-liked posts were analyzed. Poster demographics including age, gender, region, and symptom qualities and post characteristics including type, number, timing relative to surgery, tone, and satisfaction were collected. Categorical variables were compared utilizing chi-squared test. Univariate and multivariate regression were performed.

RESULTS

The most popular post types included single photo (55.2%), multiple photos (18.8%), or single video (18.2%). Of all, 70.6% posts had fewer than 50 "likes." Patients accounted for 51.8% of posts, followed by surgeons (13.3%), other health care providers (11.7%), and physical therapists (8.8%). Women (66.7%) outnumbered men (33.3%). Fifty-five percent of posts were domestic. Posts mostly depicted postoperative care (85.6%). The most frequently mentioned symptoms were pain, burning, numbness, and tingling. Of all posts, 45.1% had a positive tone, 49.1% neutral, and 5.7% negative. Univariate analysis revealed that posters who were patients, underwent open CTR, and were female were more likely to post negative sentiments.

CONCLUSIONS

Most posts regarding CTR are from patients, are postoperative, and are positive or neutral. Although rare, negative posts were more likely to originate from posters who are patients, female, or underwent open CTR. With this information, surgeons will be better prepared to address patient concerns, set patient expectations, and enter the social media themselves.

A High Incidence of Perineal Post-Related Complications After Hip Arthroscopy Is Self-Reported by Patients in Anonymous Online Forums

Purpose

To evaluate online, self-reported pudendal nerve or perineal injuries related to the use of a perineal post during hip arthroscopy.

Methods

Public posts on Reddit and the Health Organization for Pudendal Education were searched to identify anonymous individuals reporting symptoms of pudendal nerve or perineal injury following hip arthroscopy. Included posts were by any individual with a self-reported history of hip arthroscopy who developed symptoms of pudendal nerve injury or damage to the perineal soft tissues. Demographic information and details about a person's symptoms and concerns were collected from each post. Descriptive statistics were used to analyze the data.

Results

Twenty-three online posts reported on a perineal post-related complication following hip arthroscopy. Sex information was available in 16 (70%) posts (8 male, 8 female). Twenty-two posts reported a sensory injury, and 4 posts reported a motor injury with sexual consequences (sexual dysfunction, dyspareunia, impotence). Symptom duration was available in 15 (65%) posts (8 temporary, 7 permanent). Permanent symptoms included paresthesia of the perineum or genitals (7) and sexual complaints (5). Two posts stated they were counseled preoperatively about the possibility of this injury. Zero patients reported that a postless hip arthroscopy alternative was an option made available to them before surgery.

Conclusions

A high incidence of permanent pudendal nerve, perineal skin, and genitourinary/sexual complications are self-reported and discussed online by patients who have undergone post-assisted hip arthroscopy. These patients report being uninformed and undereducated about the possibility of sustaining a post-related complication. No patient reported being informed of postless hip arthroscopy preoperatively.

Clinical Relevance

Identifying and evaluating self-reported patient information in online medical forums can provide important information about patient experiences and outcomes.

Perceived outcomes of periacetabular osteotomy

Aims

Social media is a popular resource for patients seeking medical information and sharing experiences. periacetabular osteotomy (PAO) is the gold-standard treatment for symptomatic acetabular dysplasia with good long-term outcomes. However, little is known regarding the perceived outcomes of PAO on social media. The aims of this study were to describe the perceived outcomes following PAO using three social media platforms: Facebook, Instagram, and X (formerly known as Twitter).

Methods

Facebook, Instagram, and X posts were retrospectively collected from 1 February 2023. Facebook posts were collected from the two most populated interest groups: "periacetabular osteotomy" and "PAO Australia." Instagram and X posts were queried using the most popular hashtags: #PAOwarrior, #periacetabularosteotomy, #periacetabularosteotomyrecovery, #PAOsurgery, and #PAOrecovery. Posts were assessed for demographic data (sex, race, location), perspective (patient, physician, professional organization, industry), timing (preoperative vs postoperative), and perceived outcome (positive, negative, neutral).

Results

A total of 1,054 Facebook posts, 1,003 Instagram posts, and 502 X posts were consecutively assessed from 887 unique authors. The majority (63.3%) of these posts were from patients in the postoperative period, with a median of 84 days postoperatively (interquartile range 20 to 275). The longest follow-up timeframe postoperatively was 20 years. Regarding perceived outcomes, 52.8% expressed satisfaction, 39.7% held neutral opinions, and 7.5% were dissatisfied. Most dissatisfied patients (50.9%) reported pain (chronic or uncontrolled acute) as an attributing factor.

Conclusion

Most PAO-perceived surgical outcomes on social media had a positive tone. Findings also indicate that a small percentage of patients reported negative perceived outcomes. However, dissatisfaction with PAO primarily stemmed from postoperative pain. Social media posts from other sources (physicians, hospitals, professional organizations, etc.) trend towards neutrality. Healthcare providers must consider the social media narratives of patients following PAO, as they may reveal additional outcome expectations and help improve patient-centred care, create informed decision-making, and optimize treatment outcomes.

Social Media Posts About Distal Radius Fracture: A Cross-Sectional Analysis of Patient and Provider Perspectives

BACKGROUND

Social media offers a popular, unfiltered source of patient and provider perspectives on health care. This study investigated the characteristics of social media posts referencing distal radius fracture (DRF).

METHODS

Content was queried from Instagram from February 06, 2019, to December 08, 2021, using the hashtags "#distalradiusfracture" and "#wristfracture." The 1500 most-liked posts were analyzed. Poster demographics including age, gender, region, laterality, and treatment type and post characteristics including post type, number, content, timing relative to treatment, tone, and satisfaction were examined. Variables were compared using χ2 tests. Univariate, multivariate, and stepwise regression were performed.

RESULTS

The most popular post formats were single photo (44.5%), multiple photos (32.3%), and single video (13.9%). Patients (40.3%) were the most common poster followed by surgeons (33.4%). Men (48.7%) and women (51.3) were evenly represented. Of the total posts, 87.7% depicted the post-treatment phase of care; 54.8% of posts depicted operative management, while 26.6% depicted non-operative management; and 73.7% of posts were positive in tone, 18.7% neutral, and 7.6% negative. Univariate analysis demonstrated that posters who were patients, friends/family of patients, female, and posts with >100 "likes" were more likely to share negative tones. Multivariate and stepwise regression were consistent with the above.

CONCLUSION

Most posts regarding DRF originate from patients, are post-treatment, and are positive. Negative tone is associated with posts from patients, family/friends of patients, female posters, and posts with >100 likes. With this information, surgeons will be better prepared to address patient concerns, manage expectations, and actively participate in social media themselves.

#Ophthalmology: Popular ophthalmology hashtags as an educational source for ophthalmologists, an Instagram study

Purpose

This study aims to determine the content and intent of posts published under popular ophthalmology hashtags and to determine whether these posts were educational for ophthalmologists.

Methods

A web-based, cross-sectional study design was used to evaluate the top public posts of five popular hashtags on three consecutive days by two ophthalmology specialists. The first 100 relevant English posts of each hashtag were studied. Selected hashtags were #Ophthalmology, #ophthalmosurgery, #ophthalmologyresident, #ophthalmologist, and #ophthalmicphotography. Posts were classified according to the type of post, post author, post intent, and whether the post was educational. Posts deemed educational were then categorized separately using the same classification system as above to determine whether there were defining characteristics of educational posts.

Results

One thousand posts were recorded and analyzed and a total of 500 posts were included in the study. The majority of posts 79.8% (n = 399), were by medical doctors with 95% (n = 379) being ophthalmology specialists. Sixty-three percent of posts (n = 315) were deemed educational, 25% promotional (n = 127), and 12% (n = 58) were entertainment posts. Medical retina (n = 119) and anterior segment (n = 90) were the most common subspecialties explored. #ophthalmicphotography (P = 0.001) was the hashtag with the highest number of educational posts (n = 91). The least educational hashtag was #ophthalmologist with only 44% of posts (n = 44) that were deemed to be educational. One hundred percent of glaucoma posts (n = 19), 98% of cornea posts (n = 41), and 99% of medical retina posts (n = 118) were found to be educational which was significantly more educational than the other topics posted (P ≤ 0.001).

Conclusion

Ophthalmologists are the main authors of posts in popular ophthalmology hashtags. The majority of posts were educational posts with promotional posts being the second most common intent. The authors conclude that while Instagram is a possible source of ancillary education for the visual specialty of ophthalmology, careful selection of hashtags and post authors are needed for maximum benefit.

Patients Report A Positive Experience on Social Media After Bankart Repair

Purpose

The purpose of this cross-sectional study was to analyze publicly available posts on Instagram and Twitter to gain an understanding of patients’ perspectives regarding Bankart injuries and repair.

Methods

Public posts on Instagram and Twitter were queried from June 1, 2019, to June 1, 2020, with the following hashtags: #Bankart #Bankartrepair #Bankartlesion #labrumrepair #labralrepair #shoulderdislocation. Posts that did not contain those hashtags were excluded. In addition, posts that included that hashtag but displayed content unrelated to Bankart repair were excluded. A binary categorical system was used for media format (picture or video), perspective (patient, family or friend, physician, hospital or physical therapy group, professional organization, news media, or industry), timing (preoperative, postoperative, nonoperative), tone (positive, negative, or neutral), content (surgical site, hospital or surgeon, imaging, rehabilitation, activities of daily living [ADLs], return to work, surgical instruments, or education), post popularity (number of likes), and geographic location.

Results

1,154 Instagram posts were identified. 722/1,154 posts (62.6%) were made by patients. 600 (52.0%) of the post tones were positive, 407 (35.3%) were neutral, and 667 (57.8%) were postoperative. The most common content included in Instagram posts were ADLs (577; 50.0%), education (233; 20.2%), and rehabilitation (226; 19.6%). Overall, posts had an average of 117 likes and had geotags from 49 different countries. 155 tweets were identified, 92 of which (59.4%) were made by physicians, 113 (72.9%) were neutral, 127 (81.9%) were nonoperative, and the most common type of content posted was education (130; 83.9%). Overall, posts on Twitter had an average of 3.2 likes and had geotags from 4 different countries.

Conclusions

Instagram posts were made mostly by patients postoperatively and focused on ADLs. The tone of the Instagram posts indicates that a majority of patients have a positive experience with Bankart repair. The majority of tweets were made by physicians and provided educational information with a neutral tone.

Clinical Relevance

Exploring patient's experiences with Bankart repair on social media provides insight into their overall experience with the surgery. The majority of patients reported a positive experience.