RANKL signaling drives skeletal muscle into the oxidative profile.

The bone-muscle unit refers to the reciprocal regulation between bone and muscle by mechanical interaction and tissue communication via soluble factors. The receptor activator of NF-κB ligand (RANKL) stimulation induces mitochondrial biogenesis and increases the oxidative capacity in osteoclasts and adipocytes. RANKL may bind to the membrane bound receptor activator of NF-κB (RANK) or to osteoprotegerin (OPG), a decoy receptor that inhibits RANK-RANKL activation. RANK is highly expressed in skeletal muscle, but the contribution of RANKL to healthy skeletal muscle fiber remains elusive. Here we show that RANKL stimulation in C2C12-derived myotubes induced activation of mitochondrial biogenesis pathways as detected by RNA-seq and western blot. RANKL expanded the mitochondrial reticulum, as shown by mitochondrial DNA quantification and MitoTracker staining, and boosted the spare respiratory capacity. Using MEK and MAPK inhibitors, we found that RANKL signals via ERK and p38 to induce mitochondrial biogenesis. The soleus from OPG-/- and OPG+/- mice showed higher respiratory rates compared to C57BL6/J wild-type (WT) mice, which correlates with high serum RANKL levels. RANKL infusion using a mini-osmotic pump in WT mice increased the number of mitochondria, boosted the respiratory rate, increased succinate dehydrogenase (SDH) activity in skeletal muscle, and improved the fatigue resistance of gastrocnemius. Therefore, our findings reveal a new role of RANKL as an osteokine-like protein that impacts muscle fiber metabolism.

Bone modeling and remodeling are processes intricately related to bone health regulated by the RANKL system. The RANKL (receptor activator of NF-κB ligand) is a protein essential for bone resorption. RANKL activates RANK (receptor activator of NFκB) in the cell membrane of osteoclasts and can also bind to OPG (osteoprotegerin), which acts as a soluble decoy receptor. Therefore, the levels of RANKL and OPG determine the degree of osteoclast activation and bone resorption. Bone and muscle mechanically interact for movement as bone is a lever for skeletal muscle to exert force. They also communicate via soluble factors that reciprocally regulate their function. Skeletal muscle fibers express RANK, but the role of RANKL signaling in healthy myotubes was still unknown. Here, we propose that RANKL regulates muscle metabolism by inducing mitochondrial biogenesis. We show that RANKL increases mitochondrial area in myotubes and the expression of mitochondrial markers, boosting the spare respiratory capacity. In mice knockout for OPG, which shows high levels of RANKL and unopposed RANK-RANKL stimulation, we found higher respiratory rates than in the wild-type mice. We also infused a low dose of RANKL in wild-type mice, which is around ten times lower than the dose to induce osteoporosis, and found increased mitochondrial number and higher respiratory rates in soleus. In the gastrocnemius, we also observed increased phosphorylative respiration and improved resistance to fatigue compared to mice treated with the vehicle solution. Our findings indicate that RANKL regulates both bone and muscle under physiological conditions by inducing mitochondrial biogenesis and oxidative metabolism in skeletal muscle fibers.

ANTEROMEDIAL OR CENTRAL ANATOMIC ACL RECONSTRUCTION? A CADAVERIC HIP-TO-TOE STUDY.

Objective: To compare anatomic anterior cruciate ligament (ACL) reconstruction between two tunnel positions in knees with isolated ligament tears. Methods: Anatomic ACL reconstruction was performed, from hip-to-toe, on 15 fresh cadaveric specimens. No associated lesions were created to enhance knee instability. The protocol was conducted in three states: (1) complete isolated ACL deficiency; (2) anatomic femoral and tibial anteromedial ACL reconstruction (AM REC); and (3) anatomic femoral and tibial central ACL reconstruction (Central REC). The reconstruction protocols were randomly assigned. The continuous mechanized pivot-shift test was recorded dynamically with a tracking system. Results: The Central REC group showed a smaller degree of internal rotation (0.6° ± 0.3° vs. 1.8° ± 0.3°, respectively, P < 0.05) and no difference in anterior translation (4.7 mm ± 0.4 mm vs. 4.5 mm ± 0.4 mm, respectively, P > 0.05) in the pivot-shift test, compared with the AM REC group. Conclusion: The central anatomic ACL reconstruction resulted in greater restriction of internal rotation than the anteromedial anatomic ACL reconstruction. Experimental Study on Cadaver.

Objetivo: Comparar a reconstrução anatômica do ligamento cruzado anterior (LCA) entre duas posições de túnel em joelhos com lesões isoladas do ligamento. Métodos: A reconstrução anatômica do LCA foi realizada, do quadril aos pés, em 15 peças anatômicas de cadáveres frescos. Não foram criadas lesões associadas para intensificar a instabilidade do joelho. O protocolo foi realizado em três estados: (1) deficiência isolada completa do LCA; (2) reconstrução anatômica femoral e anteromedial tibial do LCA (AM REC); e (3) reconstrução anatômica femoral e central tibial do LCA (Central REC). Os protocolos de reconstrução foram atribuídos aleatoriamente. O teste de pivot-shift mecanizado contínuo foi registrado dinamicamente com um sistema de rastreamento. Resultados: O grupo Central REC apresentou menor grau de rotação interna (0,6° ± 0,3° vs. 1,8° ± 0,3°, respectivamente, p < 0,05) e nenhuma diferença na translação anterior (4,7 mm ± 0,4 mm vs. 4,5 mm ± 0,4 mm, respectivamente, p > 0,05) no teste de pivot-shift, comparado ao grupo AM REC. Conclusão: A reconstrução anatômica central tibial do LCA resultou em maior restrição da rotação interna do que a reconstrução anteromedial tibial do LCA. Estudo em Cadáver Experimental.

Anteromedial or central anatomic acl reconstruction? a cadaveric hip-to-toe study / Reconstrução anatômica anteromedial ou central do lca? estudo em cadáver completo

ABSTRACT Objective: To compare anatomic anterior cruciate ligament (ACL) reconstruction between two tunnel positions in knees with isolated ligament tears. Methods: Anatomic ACL reconstruction was performed, from hip-to-toe, on 15 fresh cadaveric specimens. No associated lesions were created to enhance knee instability. The protocol was conducted in three states: (1) complete isolated ACL deficiency; (2) anatomic femoral and tibial anteromedial ACL reconstruction (AM REC); and (3) anatomic femoral and tibial central ACL reconstruction (Central REC). The reconstruction protocols were randomly assigned. The continuous mechanized pivot-shift test was recorded dynamically with a tracking system. Results: The Central REC group showed a smaller degree of internal rotation (0.6° ± 0.3° vs. 1.8° ± 0.3°, respectively, P < 0.05) and no difference in anterior translation (4.7 mm ± 0.4 mm vs. 4.5 mm ± 0.4 mm, respectively, P > 0.05) in the pivot-shift test, compared with the AM REC group. Conclusion: The central anatomic ACL reconstruction resulted in greater restriction of internal rotation than the anteromedial anatomic ACL reconstruction. Experimental Study on Cadaver.

RESUMO Objetivo: Comparar a reconstrução anatômica do ligamento cruzado anterior (LCA) entre duas posições de túnel em joelhos com lesões isoladas do ligamento. Métodos: A reconstrução anatômica do LCA foi realizada, do quadril aos pés, em 15 peças anatômicas de cadáveres frescos. Não foram criadas lesões associadas para intensificar a instabilidade do joelho. O protocolo foi realizado em três estados: (1) deficiência isolada completa do LCA; (2) reconstrução anatômica femoral e anteromedial tibial do LCA (AM REC); e (3) reconstrução anatômica femoral e central tibial do LCA (Central REC). Os protocolos de reconstrução foram atribuídos aleatoriamente. O teste de pivot-shift mecanizado contínuo foi registrado dinamicamente com um sistema de rastreamento. Resultados: O grupo Central REC apresentou menor grau de rotação interna (0,6° ± 0,3° vs. 1,8° ± 0,3°, respectivamente, p < 0,05) e nenhuma diferença na translação anterior (4,7 mm ± 0,4 mm vs. 4,5 mm ± 0,4 mm, respectivamente, p > 0,05) no teste de pivot-shift, comparado ao grupo AM REC. Conclusão: A reconstrução anatômica central tibial do LCA resultou em maior restrição da rotação interna do que a reconstrução anteromedial tibial do LCA. Estudo em Cadáver Experimental.

Efeitos de 16 semanas de exercícios multimodais na capacidade funcional e cognitiva em idosos / Effects of 16 weeks of multimodal exercise on functional and cognitive capacity in the elderly / Efectos de 16 semanas de ejercicios multimodales sobre la capacidad funcional y cognitiva de los ancianos

O presente estudo buscou verificar o efeito de 16 semanas de exercícios multimodais na capacidade funcional e cognitiva em idosos comunitários do município de Tocantinópolis-TO. A pesquisa teve caráter descritivo, longitudinal e quase- experimental. Participaram deste estudo 44 idosos, sendo 20 do sexo masculino, com média de idade de 69 ± 7,3 anos e 24 do sexo feminino, com média de idade de 66 ± 7,6 anos. A seleção dos participantes foi realizada por meio da técnica de amostragem por conveniência em utentes da Academia da Melhor Idade (AMI), em Tocantinópolis-TO. Antes e após as 16 semanas de intervenção com exercícios multimodais, foram aplicadas: a bateria Senior fitness test de Rikli & Jones (2013) e avaliação do estado cognitivo com o Mini Exame de Estado Mental (MEEM). Em relação às variáveis da capacidade funcional, apenas o teste de "Caminhada de 6 minutos" apresentou diferença significativa nos participantes do sexo masculino (C6Min pré = 516,2 metros vs. pós = 545,8 metros; p < 0,05). Nas mulheres foram observadas diferenças significativas nas variáveis "Levantar e Sentar da Cadeira" (LSC pré = 12,5 repetições vs. Pós = 14,1 repetições; p < 0,05), "Sentado, Caminhar 2,44 m e sentar" (SCS pré = 7,3 segundos vs. pós = 6,8 segundos; p < 0,05) e "Caminhada de 6 minutos" (C6Min pré = 483,1 m vs. pós = 514,1 m; p < 0,05). O nível de cognição apresentou diferença significativa após 16 semanas de intervenção em relação aos valores verificados no baseline, tanto para os homens (MEEM pré = 21,2 vs. pós = 23,9; p < 0,05), quanto para as mulheres (MEEM pré = 23,9 pontos vs. pós = 25,1 pontos; p < 0,05). Conclui-se que os exercícios multimodais foram efetivos na melhora da cognição em e em determinadas variáveis relacionadas à capacidade funcional nos idosos após 16 semanas de intervenção.

The present study sought to verify the effect of 16 weeks of multimodal exercises on functional and cognitive capacity in community elderly of the municipality of Tocantinópolis-TO. The research had a descriptive, longitudinal and quasi- experimental character. This study included 44 elderly subjects, 20 of whom were male, with mean age of 69 ± 7.3 years, and 24 of whom were female, with mean age of 66 ± 7.6 years. The selection of the participants was carried out by means of the technique of sampling for convenience in users of the Academy of the Best Age (AMI), in Tocantinópolis-TO. Before and after the 16 weeks of intervention with multimodal exercises, we applied: the Rikli & Jones Senior fitness test (2013) and cognitive status assessment with the Mini Mental State Examination (MEEM). Regarding the functional capacity variables, only the "6-minute walk" test showed a significant difference in the male participants (C6Min pre = 516.2 meters vs. post = 545.8 meters; p < 0.05). In women, significant differences were observed in the variables "Lift and Sit of the Chair" (LSC pre = 12.5 repetitions vs. Post = 14.1 repetitions; p < 0.05), "Sit, Walk 2.44 m and sit" (SCS pre = 7.3 seconds vs. post = 6.8 seconds; p < 0.05) and "Walk of 6 minutes" (C6Min pre = 483.1 m vs. post = 514.1 m; p < 0.05). The level of cognition was significantly different after 16 weeks of intervention from baseline values for both men (pre-MSE = 21.2 vs. post = 23.9; p < 0.05) and women (pre-MSE = 23.9 points vs. post = 25.1 points; p < 0.05). It is concluded that multimodal exercises were effective in improving cognition in and in certain variables related to functional capacity in the elderly after 16 weeks of intervention.

Este estudio buscó verificar el efecto de 16 semanas de ejercicio multimodal sobre la capacidad funcional y cognitiva de las personas mayores en el municipio de Tocantinópolis-TO. La investigación tenía un carácter descriptivo, longitudinal y casi experimental. Este estudio incluyó 44 sujetos de edad avanzada, 20 de los cuales eran hombres, de una edad media de 69 ± 7,3 años y 24 eran mujeres, con una edad media de 66 ± 7,6 años. La selección de los participantes se realizó mediante una técnica de muestreo para la conveniencia de los usuarios de la Academia de la Mejor Edad (AMI), en Tocantinópolis-TO. Antes y después de 16 semanas de intervención con ejercicios multimodales, se aplicó la Senior fitness test de Rikli & Jones (2013) y la evaluación del estado cognitivo con el Mini Examen de Estado Mental (MEEM). Para las variables de capacidad funcional, sólo el test de "caminata de 6 minutos" mostró una diferencia significativa en los participantes masculinos (C6Min pre = 516,2 metros vs. post = 545,8 metros; p < 0,05). En las mujeres se observaron diferencias significativas en las variables "Levantamiento y siéntate desde la silla" (pre = 12,5 repeticiones vs. Post = 14,1 repeticiones; p < 0,05), "Sitting, Walk 2,44 m y Sit" (pre-SCS = 7,3 segundos vs. Post = 6,8 segundos; p < 0,05) y "6 minutos de sentido" (C6S) Mínimo pre = 483,1 m vs. post = 514,1 m; p < 0,05). El nivel de cognición fue significativamente diferente después de 16 semanas de intervención respecto al valor baseline para ambos hombres (MEEM pre= 21,2 vs. post = 23,9; p < 0,05) y mujeres (MEEM pre= 23,9 puntos vs. post = 25,1 puntos; p < 0,05). Se concluye que los ejercicios multimodales fueron eficaces para mejorar la cognición en y sobre determinadas variables relacionadas con la capacidad funcional en las personas mayores después de 16 semanas de intervención.

SARS-CoV-2 infects adipose tissue in a fat depot- and viral lineage-dependent manner.

Visceral adiposity is a risk factor for severe COVID-19, and a link between adipose tissue infection and disease progression has been proposed. Here we demonstrate that SARS-CoV-2 infects human adipose tissue and undergoes productive infection in fat cells. However, susceptibility to infection and the cellular response depends on the anatomical origin of the cells and the viral lineage. Visceral fat cells express more ACE2 and are more susceptible to SARS-CoV-2 infection than their subcutaneous counterparts. SARS-CoV-2 infection leads to inhibition of lipolysis in subcutaneous fat cells, while in visceral fat cells, it results in higher expression of pro-inflammatory cytokines. Viral load and cellular response are attenuated when visceral fat cells are infected with the SARS-CoV-2 gamma variant. A similar degree of cell death occurs 4-days after SARS-CoV-2 infection, regardless of the cell origin or viral lineage. Hence, SARS-CoV-2 infects human fat cells, replicating and altering cell function and viability in a depot- and viral lineage-dependent fashion.

RANKL Impairs the TLR4 Pathway by Increasing TRAF6 and RANK Interaction in Macrophages.

High serum levels of osteoprotegerin (OPG) are found in patients with obesity, type 2 diabetes, sepsis, or septic shock and are associated with a high mortality rate in stroke. The primary known function of OPG is to bind to the receptor activator of NF-κB ligand (RANKL), and by doing so, it inhibits the binding between RANKL and its receptor (RANK). TLR4 signaling in macrophages involves TRAF6 recruitment and contributes to low-grade chronic inflammation in adipose tissue. LPS is a classical activator of the TLR4 pathway and induces the expression of inflammatory cytokines in macrophages. We have previously observed that in the presence of RANKL, there is no LPS-induced activation of TLR4 in macrophages. In this study, we investigated the crosstalk between RANK and TLR4 pathways in macrophages stimulated with both RANKL and LPS to unveil the role of OPG in inflammatory processes. We found that RANKL inhibits TLR4 activation by binding to RANK, promoting the binding between TRAF6 and RANK, lowering TLR4 activation and the expression of proinflammatory mediators. Furthermore, high OPG levels aggravate inflammation by inhibiting RANKL. Our findings elect RANKL as a candidate for drug development as a way to mitigate the impact of obesity-induced inflammation in patients.

Planejamento estratégico como um dos fatores de sucesso das organizações esportivas: um estudo sobre os clubes esportivos brasileiros que atuam no contexto olímpico / Strategic planning as one of the success factors of sports organizations: an study about Brazilian sports clubs operating in the Olympic context / Planificación estratégica como uno de los factores de éxito de las organizaciones deportivas: un estudio sobre clubes deportivos brasileños que operan en el contexto olímpico

O sucesso de uma organização esportiva depende de diversos fatores, um deles é a estruturação de um planejamento estratégico. Este estudo teve como objetivo principal identificar a existência e analisar importância do planejamento estratégico nos principais clubes esportivos brasileiros que atuam em nível Olímpico. Como resultado, foi possível constatar que os clubes brasileiros analisados possuem planejamentos e seguem com afinidade e coerência recomendações existentes na literatura. E este fato é um indício que o planejamento é o primeiro e um dos passos para se alcançar sucesso, seja ele administrativo ou esportivo. Outros fatores acabam por existir e influenciar o modo operante de organizações brasileiras, como neste caso, clubes esportivos. Por outro lado, é fundamental que o planejamento estratégico, passe a existir no esporte brasileiro, a fim de que este tenha um maior e melhor profissionalismo em termos organizacionais.

The success of a sports organization depends on several factors, one of them is the structuring of a strategic plan. The main objective of this study was to identify the existence and analyze the importance of strategic planning in Brazilian sports clubs that operate at the Olympic level. As a result, it was possible to verify that Brazilian clubs have plans and follow the recommendations in the literature with affinity and consistency. And this fact is an indication that strategic planning is the first step towards administrative or sports success. Other factors influence the way in which Brazilian sports clubs operate. However, it is essential that strategic planning comes to exist in Brazilian sport, for greater and better professionalism in organizational terms.

Versión en español del resumen. El éxito de una organización deportiva depende de varios factores, uno de ellos es la estructuración de un plan estratégico. El objetivo principal de este estudio fue identificar la existencia y analizar la importancia de la planificación estratégica en los principales clubes deportivos brasileños que operan a nivel olímpico. Como resultado, fue posible verificar que los clubes brasileños tienen planes y siguen las recomendaciones en la literatura con afinidad y consistencia. Y este hecho es una indicación de que la planificación es el primero y uno de los pasos para lograr el éxito, ya sea administrativo o deportivo. Otros factores influyen en la forma en que operan los clubes deportivos brasileños. Sin embargo, es esencial que exista una planificación estratégica en el deporte brasileño, para una mayor y mejor profesionalidad en términos organizacionales.

RANKL induces beige adipocyte differentiation in preadipocytes.

The receptor activator of nuclear factor-κB (NF-κB) (RANK), its ligand (RANKL), and the decoy receptor osteoprotegerin (OPG) are a triad of proteins that regulate bone metabolism, and serum OPG is considered a biomarker for cardiovascular diseases and Type 2 diabetes; however, the implications of OPG in adipose tissue metabolism remains elusive. In this study, we investigate RANK-RANKL-OPG signaling in white adipose tissue browning. Histological analysis of osteoprotegerin knockout (OPG-/-) mice showed subcutaneous white adipose tissue (sWAT) browning, resistance for high-fat diet-induced weight gain, and preserved glucose metabolism compared with wild-type (WT) mice. Stromal vascular fraction (SVF) cells from sWAT of OPG-/- mice showed multilocular morphology and higher expression of brown adipocyte marker genes compared with those from the WT group. Infusion of RANKL induced browning and elevated respiratory rates in sWAT, along with increased whole body oxygen consumption in mice measured by indirect calorimetry. Subcutaneous WAT-derived SVF and 3T3-L1 cells, but not mature white adipocytes, differentiated into beige adipose tissue in the presence of RANKL. Moreover, SVF cells, even under white adipocyte differentiation, showed multilocular lipid droplet, lower lipid content, and increased expression of beige adipocyte markers with RANKL stimulation. In this study, we show for the first time the contribution of RANKL to increase energy expenditure by inducing beige adipocyte differentiation in preadipocytes.

Association Between Meniscal and Chondral Lesions and Timing of Anterior Cruciate Ligament Reconstruction.

BACKGROUND: Rupture of the anterior cruciate ligament (ACL) is a common sports injury and is known to be associated with an increased risk of knee osteoarthritis. Several studies have indicated that the risk of additional injuries to the menisci and articular cartilage increases with delays in the treatment of ACL tears. However, no consensus has been reached regarding the ideal timing for ACL reconstruction in terms of preventing secondary lesions. PURPOSE: To determine how the time elapsed between an ACL lesion and its reconstruction affects the incidence of meniscal and chondral lesions. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Medical records of 764 patients who underwent primary ACL reconstruction were reviewed. Data from arthroscopic findings that included information about meniscal lesions and full-thickness articular cartilage lesions at the time of surgery were collected. The association between time elapsed between ACL lesion and reconstruction surgery and incidence of articular cartilage and meniscal lesions was analyzed by chi-square or Fisher exact test. The risk of secondary lesion was calculated by odds ratios (ORs) obtained from simple logistic regression analysis. RESULTS: A positive correlation was observed between time after injury and the presence of any articular lesions (P = .003), cartilage lesions (P = .01), and medial meniscus lesions (P < .001). When analyzing the risk of secondary lesion relative to the reference period (<2 months), it was observed that the odds of finding any articular injury at the time of ACL reconstruction increased when the time from ACL injury to surgery was between 12 and 24 months (OR = 2.62) and >24 months (OR = 5.88). Furthermore, the odds of lesions on the medial meniscus increased when the timing between injury and surgery was 6 to 12 months (OR = 2.71) and continued to increase when the timing was 12 to 24 months (OR = 3.78) and >24 months (OR = 9.07). CONCLUSION: Associated articular lesions are more common if ACL reconstruction is delayed by ≥6 months (medial meniscus lesion) and ≥1 year (chondral or any meniscal lesion).

Avaliação clínica e nutricional de idosos cadastrados na estratégia saúde da família Warislândia, estado do Pará / Nutritional and clinical evaluation of elderly people registered with the family health strategy, Warislândia, state of Pará

quado ou eutrófico) para o IMC e uma quantidade expressivados entrevistados (44, 6%) estava com sobrepeso, oque fornece indicadores para o planejamento de ações deprevenção de doenças e agravos e a busca pela promoçãoda saúde dos idosos nas microáreas da Estratégia Saúdeda Família.

Increasingly, the proportion of elderly people in the world is growing. People are living longer and causing major changes in various sectors of society. This approaching critical limit is due mainly to the technological advancement of medicine and to changes in lifestyle. Therefore, the description of the nutritional and clinical profile of elderly people offers support for the local planning of health actions, and consequently, support for active and healthy aging. This is a cross-sectional study conducted with 83 elderly people at a Family Health Strategy location in the city of Ananindeua, Pará, from September 2010 to January 2011. A research protocol was applied that contained information about social, demographic, and clinical variables, lifestyle (alcoholism, smoking, and sedentary) and medication use. Epi Info 3.5.2 software was used for statistical analysis. Of the elderly people evaluated, 62.6% were female and the mean age was 69.3 years, 37.3% were married and 27.7% were widowed. Considering their origins, 77.1% were from Pará and just 13.3% from Maranhão. The diseases reported more frequently were systemic arterial hypertension (60.2%), arthrosis (32.5%), CVA (16.9%), and osteoporosis (14.4%). Regarding lifestyle, 13.2% were alcoholics, 18.1% were smokers, and 73.8% did no physical exercise. Among these elderly people, 68.7% regularly took medications. A significant number of the seniors had systemic arterial hypertension. It was found that 38.5% of the seniors were in the normal range for BMI, and a significant number (44.6%) were overweight. This data provides indicators for planning disease and disorder prevention actions and those promoting the health of elderly people in the microareas of the Family Health Strategy.

Updates in biological therapies for knee injuries: bone.

Bone is a unique tissue because of its mechanical properties, ability for self-repair, and enrollment in different metabolic processes such as calcium homeostasis and hematopoietic cell production. Bone barely tolerates deformation and tends to fail when overloaded. Fracture healing is a complex process that in particular cases is impaired. Osteoprogenitor cells proliferation, growth factors, and a sound tridimensional scaffold at fracture site are key elements for new bone formation and deposition. Mechanical stability and ample vascularity are also of great importance on providing a proper environment for bone healing. From mesenchymal stem cells delivery to custom-made synthetic scaffolds, many are the biological attempts to enhance bone healing. Impaired fracture healing represents a real burden to contemporary society. Sound basic science knowledge has contributed to newer approaches aimed to accelerate and improve the quality of bone healing.

Estudo comparativo da medida da rotação vertebral pelos métodos de Nash & Moe e método de Raimondi / Comparative study of the measurements of the vertebral rotation using Nash & Moe and Raimondi methods

Neste estudo foram avaliados a sensibilidade e precisão dos métodos de Nash e Moe e de Raimondi para a medida da rotação da vértebra torácica e lombar.Três cirurgiões de coluna avaliaram, independentemente, as radiografias de uma vértebra torácica (T9) e de uma vértebra lombar (L2) com graus de rotação que variaram de 0º a 60º e estabeleceram valores de acordo com o método de Nash e Moe e o método de Raimondi.Foram estudadas a concordância entre os examinadores para um determinado método, a variação das medidas obtidas na vértebra torácica e lombar a partir de uma mesma rotação real conhecida e a correlação entre um valor real conhecido de rotação vertebral e a sua estimativa pelos métodos utilizados no estudo . Os resultados mostraram boa concordância entre os examinadores para o método de Nash e Moe, tanto para a vértebra torácica (k médio = 0,66), quanto para a lombar (k médio = 0,80). Pelo método de Raimondi não houve diferença significativa entre os examinadores para a vértebra torácica, no entanto, para a vértebra lombar houve baixa reprodutibilidade do método.Para uma mesma rotação na vértebra torácica e lombar os resultados foram não concordantes pelo método de Nash e Moe, e pelo método de Raimondi os valores observados para a vértebra torácica foram significativamente maiores que os da vértebra lombar. A correlação entre os valores reais e as estimados pelo método de Raimondi para a vértebra torácica mostrou que houve diferença significativa produzida em função da rotação até 20º graus, já para a vértebra lombar, os valores obtidos foram muito próximos do real.