“My knee is cracking” – What information is available on the internet about it? A systematic appraisal of the credibility, readability and accuracy of online information about knee crepitus

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ObjectivesTo summarise and systematically appraise the credibility, readability, and accuracy of the online information about knee crepitus. DesignSystematic appraisal of online information. MethodThe top 20 URLs of two search engines (Google and Bing) for the following terms were screened for eligibility ‘knee crepitus’, ‘knee sound’, and ‘knee crackling’ (N ​= ​120 websites). Two reviewers assessed the websites for credibility (JAMA benchmark) and readability (Flesch Reading Ease and Flesch-Kincaid Grade Level tests). For accuracy, we performed a qualitative analysis creating thematic units based on the website's content and explored whether they were supported by evidence. ResultsFifty-one websites were included. There was a large variation in the overall credibility of websites, with more than half of the websites lacking credible information. The median Flesch reading ease was 62 (range ​= ​42–88) and Flesch–Kincaid grade level was 8 (range ​= ​3–12). Six key thematic units emerged from our qualitative analysis all with sub-themes within them. The main topics covered by websites were: (i) What is knee crepitus? (ii) Is knee crepitus a problem? (iii) What is the cause of knee crepitus? (iv) How to manage knee crepitus? (v) What are the health consequences of having knee crepitus? (vi) Who should I seek if I have knee crepitus? ConclusionPatients and clinicians should take caution when seeking web-based information about knee crepitus. Websites about knee crepitus lack credibility, present a large variation in readability outcomes, and there was no research evidence available to support most of their information.