Purpose YouTube is the second most accessed website worldwide and is increasingly used by patients to search for medical knowledge. This study aims to evaluate the bias and overall quality of anterior cruciate ligament (ACL) YouTube videos. Methods A list of 40 videos was compiled using the terms “ACL tear” and “ACL reconstruction.” The DISCERN criteria, which utilizes a 5-point Likert scale, was used to evaluate the bias and overall quality of each and assign a DISCERN score (DS). The presence of a US board-certified orthopedic surgeon, publisher type, publication date, number of views, and video length were recorded. Additional ACL videos on the websites of the American Orthopaedic Society for Sports Medicine and the American Academy of Orthopaedic Surgeons were rated using DISCERN. Results Mean bias DS for “ACL reconstruction” was 1.85 ± 1.57, and that for “ACL tear” was 2.30 ± 1.78. Mean overall quality DS was 2.05 ± 1.19 for “ACL reconstruction” and 2.00 ± 1.12 for “ACL tear.” Unique videos received 25,198,961 total views and were an average of 6.83 ± 7.20 min and 5.61 ± 3.21 yr old. Most videos were posted by hospitals, followed by companies. Fifty-three percent of videos included commentary by US-board certified orthopedic surgeons, and the bias and overall quality DS were significantly higher than the remaining videos (P < 0.05). Videos from the American Orthopaedic Society for Sports Medicine and American Academy of Orthopaedic Surgeons had a bias DS of 3.00 ± 0.00 and overall DS of 2.00 ± 0.00. Discussion The general public does not have access to unbiased, high-quality ACL injury videos, despite an increasing need for access to educational videos. Physicians and professional societies are educated resources who can help increase public access and availability to unbiased, high-quality video medical information online.
Background The trapezius muscle is often utilized as a muscle or nerve donor for repairing shoulder function in those with brachial plexus birth palsy (BPBP). To evaluate the native role of the trapezius in the affected limb, we demonstrate use of the Motion Browser, a novel visual analytics system to assess an adolescent with BPBP. Method An 18-year-old female with extended upper trunk (C5–6–7) BPBP underwent bilateral upper extremity three-dimensional motion analysis with Motion Browser. Surface electromyography (EMG) from eight muscles in each limb which was recorded during six upper extremity movements, distinguishing between upper trapezius (UT) and lower trapezius (LT). The Motion Browser calculated active range of motion (AROM), compiled the EMG data into measures of muscle activity, and displayed the results in charts. Results All movements, excluding shoulder abduction, had similar AROM in affected and unaffected limbs. In the unaffected limb, LT was more active in proximal movements of shoulder abduction, and shoulder external and internal rotations. In the affected limb, LT was more active in distal movements of forearm pronation and supination; UT was more active in shoulder abduction. Conclusion In this female with BPBP, Motion Browser demonstrated that the native LT in the affected limb contributed to distal movements. Her results suggest that sacrificing her trapezius as a muscle or nerve donor may affect her distal functionality. Clinicians should exercise caution when considering nerve transfers in children with BPBP and consider individualized assessment of functionality before pursuing surgery.
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