The Quality of Online Resources Available to Patients Interested in Knee Biologic Therapies Is Poor



As the use of biologic therapies for the management of knee pathology continues to expand, it is more likely that patients will turn to the Internet to gather information on this topic. Given the lack of scientific consensus on the use of biologics, care providers must understand what information is available online.


The purpose of this study was to evaluate the quality of websites that patients may use to educate themselves on knee biologics.


Websites were identified using search terms relevant to multiple biologic therapies available for knee pathology. Websites were scored based on an author-derived grading rubric, with a total of 25 possible points relating to the role of knee biologics in the diagnosis, evaluation, and treatment of knee pathology. Websites were categorized based on the source (e.g., physician-operated website vs. industry-related website). Reading level was assessed with the Flesch-Kincaid readability test.


The initial search yielded 375 results, with 96 websites meeting final inclusion criteria. Mean website score was poor, at 6.01 of the 25 possible points (24.0%). Physician websites were the most common, with 60% of the articles identified. Industry-related websites scored the lowest (mean, 3.2 ± 0.97) while hospital-related websites scored the highest (mean, 8.3 ± 2.93). Overall, websites published from hospitals or orthopedic professional societies had significantly higher scores than other websites. The search term “knee PRP” yielded higher-quality results than “knee platelet rich plasma.” Similarly, “knee BMAC” led to better results than “knee bone marrow aspirate concentrate.” The average reading level was 11.4.


Many online resources are available for patients seeking information about knee biologic therapies, but the quality of websites identified was very poor. Patients should be counseled that the information available online for knee biologic therapy is unreliable. Surgeons should play an increased role in providing resources to patients and educating them on biologic options.

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Corresponding author

Correspondence to Benedict U. Nwachukwu MD, MBA.

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Conflict of Interest

Benedict U. Nwachukwu, MD, MBA, Ryan C. Rauck, MD, Cynthia A. Kahlenberg, MD, Chukwuma Nwachukwu, BS, William W. Schairer, MD, Riley J. Williams III, MD, David W. Altchek, MD, and Answorth A. Allen, MD, declare that they have no conflicts of interest.

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This investigation was performed at the Hospital for Special Surgery.

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Nwachukwu, B.U., Rauck, R.C., Kahlenberg, C.A. et al. The Quality of Online Resources Available to Patients Interested in Knee Biologic Therapies Is Poor. HSS Jrnl 14, 322–327 (2018).

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  • biologics
  • knee
  • PRP
  • platelet-rich plasma
  • online resources