Associations between gait analysis parameters and patient satisfaction one year following primary total knee arthroplasty

BACKGROUND

The purpose of this prospective study was to understand the relation between gait outcomes and patient satisfaction one year after total knee arthroplasty (TKA).

METHODS

Seventy-nine patients were evaluated before and one year after TKA using clinical gait analysis. Specific gait outcomes were analyzed: gait speed, stance phase, range of motion (ROM) knee flexion and maximal knee flexion. The parameters of interest selected for the statistical analysis were: gait speed and maximal knee flexion during gait. The Western Ontario and MacMaster Osteoarthritis Index (WOMAC) and patient satisfaction were also assessed. The satisfaction was evaluated using a questionnaire and was splited in five categories: very unsatisfied, unsatisfied, neutral, satisfied or very satisfied. To assess associations between patient satisfaction and maximal knee flexion during gait and gait speed, an unadjusted ordinal logistic regression analysis was used. The analysis was then adjusted for covariates: age and Body Mass Index (BMI) before surgery and WOMAC pain one year after surgery.

RESULTS

All gait outcomes after TKA had significantly improved. The ordinal logistic regression analysis found significant associations between patient satisfaction and maximal knee flexion after TKA (unadjusted and adjusted) but not for gait speed.

CONCLUSION

These findings show that all patients improved their gait outcomes one year after TKA but only a higher maximal knee flexion during gait may influence the level of patient satisfaction.

Spatial distribution of schistosomiasis foci on Itamaracá Island, Pernambuco, Brazil

Acute cases of schistosomiasis have been found on the coastal area of Pernambuco, Brazil, due to environmental disturbances and disorderly occupation of the urban areas. This study identifies and spatially marks the main foci of the snail host species, Biomphalaria glabrata on Itamaracá Island. The chaotic occupation of the beach resorts has favoured the emergence of transmission foci, thus exposing residents and tourists to the risk of infection. A database covering five years of epidemiological investigation on snails infected by Schistosoma mansoni in the island was produced with information from the geographic positioning of the foci, number of snails collected, number of snails tested positive, and their infection rate. The spatial position of the foci were recorded through the Global Positioning System (GPS), and the geographical coordinates were imported by AutoCad. The software packages ArcView and Spring were used for data processing and spatial analysis. AutoCad 2000 was used to plot the pairs of coordinates obtained from GPS. Between 1998 and 2002 5009 snails, of which 12.2% were positive for S. mansoni, were collected in Forte Beach. A total of 27 foci and areas of environmental risk were identified and spatially analyzed allowing the identification of the areas exposed to varying degrees of risk.