Is the internet a reliable source of information for patients seeking total ankle replacement?

The modern patient population relies on the Internet to provide knowledge about medical procedures. However, a gap between established medical guidelines and the information provided on the Internet exists. Because of the general poor quality of the medical information available on the Internet and the increasing popularity of total ankle replacement (TAR) with its known potential serious complications, we undertook the present study to evaluate the information on TAR available to the general public through the Internet and to determine the quality of information according to authorship type and site certification status. Three common search engines were used to identify a total of 105 websites. The TAR information quality was rated as "excellent," "high," "moderate," "low," or "unacceptable." The sites were evaluated for authorship or sponsorship, content, and other criteria. The data were analyzed as a complete set, as a comparison among authorship types (academic, private, industry, or other), and by certification status. Websites with scores of excellent or high were 35% of the sites reviewed, and 48% were ranked as poor or unacceptable. Of the authorship types, the highest quality authorship was for the industry and other sites, which rated high or excellent 46% of the time. Eight percent of the sites evaluated were certified; however, certification status was not associated with improved information quality. Our study has demonstrated a low quality of TAR information available across all website types, regardless of authorship type. We suggest a partnership between professional organizations and physicians to ensure that provider websites reflect the current indications and contraindications of TAR to enhance patient education.