13 ‘ACL: the dreaded three-letter word’: a mixed-methods content analysis of Australian news media narratives of anterior cruciate ligament rupture

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Introduction Anterior cruciate ligament (ACL) ruptures, particularly in elite athletes, often feature in news media. Media narratives may influence people’s preferences for ACL rupture management, however, news media portrayals of ACL rupture have not yet been explored.Materials and Methods We conducted a summative content analysis of Australian digital and print news media articles indexed in Factiva and ProQuest between 2023–2024 that mentioned ‘anterior cruciate ligament’. The frequency of key terms within articles was quantified to identify prevalent concepts in the data. Through interpretive thematic analysis, we examined how these concepts were portrayed and their potential to shape public perceptions of ACL rupture management.Results 525 unique articles were included. Elite athletes were the primary subject in the majority of articles (80%, n=422), most of whom were men (69%, n=293). Thematic analysis revealed a dominant narrative framing ACL rupture as a catastrophic injury requiring urgent surgery as a first-line intervention. Non-surgical pathways were framed as an active, high-risk decision deviating from standard care. This narrative was constructed through four primary themes: 1) catastrophic framing before diagnosis; 2) surgical necessity; 3) a heroic recovery journey reliant on resilience and additional support; and 4) the risk for revision surgery and career implications.Conclusion Australian news media constructs a powerful narrative capable of priming the public to favour immediate surgical intervention for ACL rupture. Clinicians should be aware of the biases reinforced by news media so that they can effectively manage patient expectations, address potential misconceptions, and facilitate informed, shared decision-making.

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