Abstract
ObjectivesThe aim of this study is to understand the current public discussion surrounding anterior cruciate ligament (ACL) injury prevention on social media and determine factors that influence levels of public engagement. MethodsWe performed a qualitative and quantitative cross-sectional analysis of ACL injury prevention techniques discussed on social media via the Twitter application programming interface (API). The Twitter API was queried from inception to May 2023 using keywords related to ACL injury and prevention. We conducted a thematic analysis of the posts and performed a sentiment analysis using natural language processing. A multivariable regression model was used to identify metadata that predicted higher engagement (media, links, tagging, hashtags). ResultsA subset of 1823 unique posts was analyzed from 1701 unique accounts. Most posts were raising awareness about ACL injury prevention (n = 733, 40.2%), followed by opinions on the topic (n = 390, 21.4%), specific prevention techniques (n = 289, 15.9%), personal experiences (n = 272, 14.9%), and research (n = 139, 7.6%). The majority consisted of posts from patients or caregivers (n = 948, 55.7%), whereas healthcare providers accounted for 14.7% of posts. Posts containing media increased Tweet engagement count by an average of 6.1 (95% CI 2.8 to 9.4, p = 0.00033) and posts discussing personal opinions increased engagement by 6.7 (95% CI 3.5 to 9.8, p = 0.00004). On sentiment analysis of all included Tweets, 822 (45.1%) posts were positive, 309 (17.0%) were negative, and 692 (38.0%) were neutral. Sentiments expressed in posts related to ACL prevention were 2.8 times more negative compared to those discussing raising awareness. ConclusionsThere is active discussion about ACL injury prevention on Twitter. The use of visual media increased public engagement. We identified a potential knowledge gap between the available prevention techniques and the perspectives of athletes, highlighting the need for healthcare professionals to enhance their engagement with ACL injury prevention on social media. Level of evidenceIII.
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