Reeson, Emily A.

Background The wide reach and unique short audiovisual nature of TikTok make it a potential modality for disseminating information about orthopaedic surgery to both patients and medical professionals. However, only a few recent studies have assessed the purpose and creators of orthopaedic surgery content on TikTok. Methods The top 100 most-liked TikTok videos about orthopaedic surgery topics were included for analysis. Data reflecting video and creator account characteristics were collected. Video validity was determined by three reviewers according to the DISCERN criteria and Kruskal-Wallis H tests were performed to correlate validity to creator and video type. Results The majority of videos were created by orthopaedic surgeons (n=57/100) and for entertainment purposes (n=82/100). Orthopaedic surgeons had the highest DISCERN score (34.7) and greater video reliability compared to all other creator types (H = 59.0-67.1, all p<0.001). Videos made for educational and procedural purposes had the highest DISCERN scores (38.9 and 40.5, respectively) while entertainment videos had lower reliability (H=-56.7 to -113.5, all p<0.05). Conclusion The most popular orthopaedic surgery-related videos on the TikTok platform are primarily being created by orthopaedic surgeons for entertainment purposes. Less frequently were videos made to educate, describe procedures, and explain the lifestyle of an orthopaedic surgeon. Potential applications of utilizing the platform by orthopaedic surgeons include case or research discussions, educational videos on different pathologies, recruitment of prospective students to the field, and entertainment highlighting a day in the life of an orthopaedic surgeon.

ABSTRACT Introduction It is controversial whether surgical correction of tethered spinal cord in non‐myelomeningocele tethered cord patients results in reversal versus stabilization of urologic (GU), gastrointestinal (GI), and musculoskeletal (MSK) symptoms. Objective To determine factors associated with clinical improvement in symptoms after spinal cord de‐tethering, and evaluate whether pre‐operative urodynamic testing predicts post‐operative clinical outcomes. Methods 213 non‐myelomeningocele children who underwent primary spinal cord de‐tethering at a quaternary children's hospital from 2012 to 2020 were retrospectively reviewed. Age at surgery, gender, and presence of GU symptoms, constipation, MSK symptoms, and urodynamic studies were collected. Pre‐operative symptoms and demographics were compared between patients with and without resolution of GU symptoms after surgery. Results Mean age at surgery was 5.36 years, 48% were female, and mean length of follow up was 1.8 years. Before surgery, 133/213 (62%) experienced a GU symptom. 105/213 (49%) patients were potty‐trained. Of 105 potty‐trained patients, 50 (48%) had daytime incontinence and 55 (52%) had nocturnal enuresis. Of 88 potty‐trained patients with urinary symptoms, 22 (25%) had resolution of and 59 (67%) had improvement following surgery. Of the 102 with constipation, 45 (44%) had improvement. Of the 116 with musculoskeletal symptoms, 60 (52%) had improvement. Patients with resolution of GU symptoms were younger (4.97 vs. 8 years, p = 0.0019). Patients with daytime urinary incontinence ( p = 0.0119) were less likely to have resolution of GU symptoms. There was no difference in urodynamic findings between patients with and without improvement or resolution of urologic symptoms. Conclusion Younger age at de‐tethering surgery is associated with improvement in genitourinary symptoms. Preoperative urodynamic studies may not be predictive of postoperative outcomes.