TikTok, #kneepain, and medical (mis)information

TikTok, a social media platform specializing in mobile short-form videos, has rapidly gained popularity, and become a powerful engine to disseminate medical information. To date, no study has characterized the quality of popular TikTok content related to orthopedics or orthopedic surgery. This analysis focused on the quality of the information of user-generated content categorized with #kneepain in the 100 highest-ranked videos. Utilizing innate TikTok algorithms to identify the top 100 results with the hashtag #kneepain, we assessed descriptive and quantitative characteristics using the DISCERN scale, conducted by four independent reviewers. We recorded content, characteristics, and provider level of the creator, and investigated correlation between DISCERN score and video characteristics (purpose, number of views, length, and creator's background). DISCERN scores ranged from 16-80, and were categorized as very poor (16-26), poor (27-38), fair (39-50), good (51-62), and excellent (63-80). 45% of the videos were rated very poor; 51% poor; 4% fair. 37% are by fitness instructors, 26% by physical therapists, 9% by physicians, 9% by chiropractors, and 19% by other. 53% provided step-by-step instructions; 24% focused on pain management, 13% served entertainment purposes, and 10% focused on personal journaling. TikTok is an increasingly popular medium for disseminating short health messages. The primary cohort using TikTok is young, at risk of non-specific knee pain, and most likely to search for content related to #kneepain. Videos posted by physical therapists had a higher average DISCERN score compared to other creators. We found no positive correlation between video quality and popularity, and no videos received a DISCERN score of Good or Excellent. Thus TikTok cannot be considered a credible source for people seeking information about knee pain. There is an unmet need for high-quality informational and treatment strategy content related to knee pain, and providers should consider creating content designed to reach this cohort.