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Published on: April 30, 2014
Differences in Public Search Interest for Anterior Cruciate Ligament and Medial Collateral Ligament Injuries: A
Nikhil Maddina1, Aditya J Bhatt1, Yincheng Jin1
1Medicine, Midwestern University Chicago College of Osteopathic Medicine, Downers Grove, USA.
Introduction:
Anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries are commonly encountered injuries in orthopedic practice. Simultaneously, patients are utilizing online resources to better understand diagnoses and treatment options. As such, understanding public interest and the accessibility of educational materials can provide insight into information-seeking behaviors and gaps in health literacy. This study used Google Trends (Google Limited Liability Corporation (LLC), Mountain View, CA) data to evaluate temporal patterns in public interest regarding ACL and MCL injuries and surgeries and to assess the readability of commonly accessed online educational materials, with the hypothesis that ACL injury and surgery-related terms would generate greater search interest and that the readability of articles for both ACL surgery and MCL surgery will exceed the American Medical Association's (AMA)-recommended sixth-grade reading level.
Methods:
Google Trends was used to extract relative search volume (RSV) data in the United States from January 2004 through December 2025 for ACL- and MCL-related injury and surgical search terms. Injury terms (e.g., "ACL tear," "MCL tear") and surgical terms (e.g., "ACL reconstruction," "MCL surgery") were queried. Monthly and seasonal variations in RSV were evaluated for ACL and MCL surgery terms. Readability analysis was performed on the first 25 text-based Google search results for "ACL surgery" and "MCL surgery" using Flesch Reading Ease and Flesch-Kincaid Grade Level metrics.
Results:
Among injury-related terms, "ACL tear" demonstrated the highest mean RSV compared to the lowest searched term (p < 0.001). Both "ACL tear" and "MCL tear" showed significant increases in RSV from 2004 to 2025 (p < 0.001). Among surgical terms, "ACL surgery" had the highest mean RSV overall, while "MCL surgery" was the most frequently searched MCL-related surgical term. RSV for both ACL and MCL surgery increased significantly over time. No significant differences in RSV were measured across seasons or months for either ACL surgery or MCL surgery. On readability analysis, the mean Flesch-Kincaid Grade Level was 10.4 for ACL surgery materials and 10.1 for MCL surgery materials, exceeding AMA recommendations. Only 4% of ACL surgery articles and 0% of MCL surgery articles met the recommended sixth-grade reading level.
Conclusion:
Public interest in ACL and MCL injuries, tears, and surgical treatments has substantially increased in the past two decades, with ACL injury and surgery-related terms generating greater search interest than MCL injury and surgery-related terms, respectively. Patients preferentially searched for "tear" terminology rather than "injury" terminology, and "surgery" was the most common surgical search term. Despite growing public interest in ACL and MCL information, the readability of online educational materials remains significantly above recommended levels, possibly limiting patient comprehension. Future efforts should focus on improving the accessibility and readability of online orthopedic educational resources.
