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World J Orthop. Feb 18, 2020; 11(2): 82-89
Published online Feb 18, 2020. doi: 10.5312/wjo.v11.i2.82
Revision total hip arthroplasty: An analysis of the quality and readability of information on the internet
Gerard Anthony Sheridan, Carl O’Brien, Bassam A Masri, Clive P Duncan, Donald S Garbuz
Gerard Anthony Sheridan, Carl O’Brien, Bassam A Masri, Clive P Duncan, Donald S Garbuz, Department of Orthopaedics, University of British Columbia, Vancouver V6T 1Z4, British Columbia, Canada
Author contributions: Sheridan GA designed the research, performed the research, analyzed the data, and wrote the paper; O’Brien C collected data and analyzed data; Masri BA analyzed the data and wrote the paper; Duncan CP contributed to the writing of the paper; Garbuz DS designed the research and wrote the paper.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Gerard Anthony Sheridan, MCh, FRCS, Surgeon, Orthopaedic Surgeon-specialist resident, Department of Orthopaedics, University of British Columbia, Vancouver V6T 1Z4, British Columbia, Canada. sheridga@tcd.ie
Received: July 12, 2019
Peer-review started: July 19, 2019
First decision: September 21, 2019
Revised: October 21, 2019
Accepted: November 28, 2019
Article in press: November 28, 2019
Published online: February 18, 2020
Processing time: 222 Days and 8.5 Hours
Abstract

The demand for revision total hip arthroplasty (THA) is increasing. Information quality on the internet has been extensively analysed in relation to primary THA but no such analysis has ever been performed for revision THA. Our aim was to assess the quality and readability of this information. Three major internet search engines were searched for information on revision THA. All websites were assessed for quality of information using the DISCERN score, the Journal of the American Medical Association benchmark criteria and a novel scoring system specific to revision THA [Vancouver Revision Arthroplasty Information (VRAI) score]. Website readability was assessed, as was presence of the Health On the Net Foundation (HON) seal. The majority of websites (52%) were academic with a post-graduate reading level. Only 6.5% of websites had the HON seal. Twenty-eight percent of websites had a ‘good’ DISCERN score and only 28% had a ‘good’ score with the novel VRAI scoring system. Health information websites had significantly higher rates of ‘good’ VRAI scores (P = 0.008). Websites with the HON seal had significantly higher DISCERN scores (P = 0.01). All governmental websites were at a reading level suitable for patient review. Information on the internet relating to revision THA is of low quality, much lower than the quality of information on primary THA. We recommend governmental websites for their readability and health information websites for their quality of information specific to revision THA. Websites with the HON seal provide higher quality information and should be recommended to patients as reading material regarding revision THA.

Keywords: Revision; Hip; Arthroplasty; Internet; Quality; Readability

Core tip: Information related to revision total hip arthroplasty (THA) on the internet is of generally poor quality and seems to be of lower quality than information relating to primary THA on the internet. Only 28% of websites had ‘good’ quality information as determined by both the validated DISCERN score and the novel revision THA-specific Vancouver Revision Arthroplasty Information score. We recommend that patients use governmental websites as these are the most readable on the internet. We also recommend the use of health information websites as these were of the highest quality overall. Academic websites should be avoided as sources of patient information given their advanced readability and overall lack of patient-relevant content relating to revision THA.