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Patient-facing materials for hip and knee preservation surgery are written well above recommended reading level
Brendan Gleason1, Clark Chen1, Keenan Sobol1
1Jefferson Einstein Philadelphia Hospital, Department of Orthopaedic Surgery, 5501 Old York Rd, Philadelphia, PA 19141, United States.
Abstract:
Hip and knee preservation have rapidly expanded over the past decade. As technology and surgeon familiarity have increased, patient interest in this field has also grown. Health literacy data demonstrates that up to 43% of US adults have basic or below-basic reading skills. Federal and medical agencies recommend patient facing materials (PFMs) be written no higher than a sixth to eighth grade level. We identified PFMs pertaining to hip and knee preservation surgery from top orthopaedic institutions, as ranked by the 2025 US News & World Report. PFMs were assessed using validated readability formulas. We then used Spearman rank correlation to examine the association between the hospital's ranking and the readability of its PFMs. A multivariate analysis was also conducted to explore whether institutional characteristics had any significant relationship with readability scores. PFMs for hip and knee preservation surgery provided by highly ranked orthopaedic institutions were commonly written well above the recommended sixth to eighth grade reading level. There was no significant statistical relationship between institutional characteristics and readability. PFMs for hip and knee preservation surgery are widely available but are written at a much higher reading level than is recommended. To increase accessibility, enhance healthcare literacy, and improve patient outcomes, institutions should simplify these materials to meet recommended readability standards. The gap between the reading level of available materials and the literacy of the target patient population may hinder patient comprehension, engagement, and informed consent, potentially impacting healthcare outcomes.
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