The readability of total elbow arthroplasty educational materials

The purpose of this study was to evaluate the readability of patient education materials related to total elbow arthroplasty (TEA) and to compare readability across clinical practice and general health information websites.

A Google search using the term "Total Elbow Arthroplasty patient information" was performed in September 2025. The first 25 websites containing written patient educational materials on TEA were included, excluding websites with only graphics, videos, or tables. Websites were categorized as clinical practice or general health information sources. Non-educational content was removed, and the remaining text was then analyzed using 9 validated readability formulas to calculate grade level scores for each source. Comparisons between clinical practice and general health information websites were performed using independent sample t-tests.

Of the 25 patient education materials analyzed, 11 (44%) were from clinical practice websites and 14 (56%) from general health information websites. The mean reading level across all materials was 12.1 ± 2.5, ranging from 7.87 to 17.25. None of the educational materials met the recommended sixth-grade reading level set by the National Institutes of Health, American Medical Association, and the US Department of Health and Human Services. Clinical practice websites demonstrated significantly lower reading levels compared to general health information websites across most formulas (10.4 ± 2.2 vs. 13.4 ± 1.9; P = .002).

Online patient educational materials for TEA are written well above recommended reading levels. Although clinical practice websites are comparatively more readable than general health information sites, both remain above recommended standards. These findings underscore the need for plain language revisions and patient-centered design to improve comprehension and support informed decision-making among TEA candidates.