Evaluating patient perspectives on total ankle arthroplasty through social media sentiment analysis

Abstract

As social media and medicine increasingly intersect, patients turn to platforms for diagnostic and therapeutic testimonials. This study examines patient sentiment and characterizes topics, media types, timing, and authorship of social media posts related to total ankle replacements. A systematic search for “ankle replacement” was conducted on Facebook® and Instagram®, analyzing 300 posts equally split between platforms. Posts were categorized by topic, media type, timing, and authorship, while sentiment analysis used natural language processing and machine learning. A chi-square test assessed differences in sentiment distribution and content characteristics, with significance set at p≤0.05. The most common topic was updates (81 %), with patients sharing recovery milestones more often than complications. Posts primarily featured text (63 %), often accompanied by clinical photos (28 %) and radiographs (9 %). Most posts were from the post-operative phase (72 %) and were predominantly authored by patients (82 %). Sentiment analysis revealed an overall positive tone (72 %), emphasizing gratitude, recovery celebrations, and community support. No statistically significant differences were found between platforms in sentiment (p = 0.07) or media type (p = 0.06), though differences existed in timing, authorship, and topic (p < 0.001). Social media largely presents total ankle replacements in a positive light, with patient-shared recovery updates dominating. While these posts foster encouragement, surgeons should counsel patients on potential biases, as negative experiences may be underrepresented, potentially influencing patient expectations and surgical decision-making.