Bilibili and TikTok as sources of medical information on osteonecrosis of the femoral head: A cross-platform content analysis

Background Osteonecrosis of the femoral head is a disabling orthopedic condition often diagnosed late due to limited public awareness. Social media platforms such as Bilibili and TikTok have become key sources of health information, yet the quality of content varies widely. Methods We searched Bilibili and TikTok on February 12, 2025, using the Chinese term “股骨头坏死” (osteonecrosis of the femoral head), which serves as both the scientific and commonly used colloquial expression. A total of 162 videos were analyzed using the modified DISCERN (mDISCERN), Global Quality Score, Video Information and Quality Index (VIQI), and Patient Education Materials Assessment Tool evaluation tools. User engagement metrics and content quality scores were compared between platforms using the Mann–Whitney U test and the Chi-square test. Results TikTok videos demonstrated significantly higher user engagement, reflected by greater numbers of likes, favorites and comments. However, Bilibili hosted a wider range of creators and provided more in-depth examination and diagnosis-oriented content. TikTok achieved higher scores in overall video quality (mDISCERN-sum and VIQI-sum), particularly in information flow，information accuracy and understandability, whereas Bilibili performed better in actionability, offering more detailed procedural or instructional guidance. Professional creators produced videos with higher scores in information flow and information accuracy, whereas non-professionals achieved higher actionability scores. Conclusion TikTok and Bilibili serve complementary functions in osteonecrosis of the femoral head (ONFH) education: TikTok enhances awareness of early symptoms, while Bilibili supports deeper understanding of imaging, staging and treatment. Building on these strengths, future digital health efforts should integrate professional expertise, improve content governance and apply AI-assisted tools to deliver accurate, accessible and actionable ONFH information for earlier detection and better disease management.