Resumo Objetivo Avaliar se a aplicação das escalas subjective elbow value (SEV) e Patient-rated Tennis Elbow Evaluation (PRTEE) apresentam resultados similares na avaliação de pacientes com epicondilite lateral do cotovelo. Métodos Trinta e sete indivíduos com diagnostic de epicondilite lateral do cotovelo foram avaliados no ambulatório de cirurgia do ombro e cotovelo do nosso hospital. O diagnóstico foi realizado com a história clínica da patologia, exame físico, raio-x, e ultrassonográfia. Foram utilizadas as escalas SEV e PRTEE, e os resultados foram comparados estatisticamente, usando-se como nível de significância 5% (p ≥ 0,05). Resultados Encontramos uma relação estatisticamente significante entre os valores obtidos pelas escalas SEV e PRTEE quando aplicadas no grupo de pacientes portadores de epicondilite lateral (p= 0,017). Conclusão Subjective elbow value apresentou resultados similares ao PRTEE na avaliação de pacientes com diagnóstico de epicondilite lateral do cotovelo.

Abstract Objective To verify if the subjective elbow value (SEV) scale presents similar results to those of the Patient-rated Tennis Elbow Evaluation (PRTEE) scale in the evaluation of patients with lateral elbow epicondylitis (LEE). Methods Thirty-seven patients were diagnosed with LEE in the outpatient service of our hospital through clinical history, physical examination, X-ray, and ultrasonography. The SEV and PRTEE scales were used and their results were compared using a significance level ≥ 5% (p ≥0.05). Results A statistically significant relationship was found between the values of SEV and PRTEE in the group of patients studied (p= 0.017). Conclusion Subjective elbow value presented similar results to PRTEE in the evaluation of patients with diagnosis of LEE.

Abstract Over the last decades, alloy 718 usage has expanded and requirements imposed by its industrial applications became more critical. The knowledge about grain boundary character distribution (GBCD) in alloy 718 and its effect on properties improvement is mostly built based on iterative processing through cold rolling steps interspersed with solution annealing. Alloy 718 is found in the industry in many different forms and geometries, and fabricated by multiple thermomechanical processes such as wire drawing, rolling, forging or extrusion. The present study focused on understanding how wires respond to deformation mode related to drawing in regard to GBCD evolution, crystallographic orientation, precipitation of δ-phase and grain size. Lastly, assessing the resulting mechanical properties. The findings show that microstructural evolution is a consequence of competing mechanisms such as strain induced boundary migration, recrystallization, grain growth and phase precipitation. The deformation gradient along wire cross section plays an important role in affecting microstructural features, such as δ precipitation, GBCD and microtexture.

RESUMO Objetivo: Avaliar o resultado funcional do tratamento artroscópico das lesões anterossuperiores do manguito rotado. Métodos: Avaliação de 59 pacientes com lesão anterossuperior submetidos a tratamento cirúrgico. O tempo de seguimento foi de 5,5 anos. As lesões foram diagnosticadas por exame físico e de imagem. A análise estatística comparou os resultados pré e pós-operatórios de amplitude de movimento e da escala da UCLA, com teste de pontos sinalizados de Wilcoxon, nível de significância de 5% (p≤0,05), a relação entre a lesão do subescapular e o pós-operatório pela aplicação do teste de Mann-Whitney, e entre o tempo de dor e a escala da UCLA pela correlação de Spearman. Resultados: Houve melhora estatisticamente significativa (p<0,001) comparando-se a amplitude de movimento e a escala da UCLA nos períodos pré e pós-operatórios. 39% dos casos foram classificados como excelentes resultados, 33,9% bons, 23,7% regulares e 3,4% ruins. Houve relação estatisticamente significativa entre o tipo de lesão do subescapular e o resultado funcional, entre o tempo de dor e a escala da UCLA pós-operatória. Registramos cinco complicações, quatro re-rupturas e uma capsulite adesiva. Conclusão: O tratamento artroscópico das lesões anterossuperiores apresentou resultados satisfatórios, com 8,5% de complicações. Nível de Evidência IV, Série de Casos.

ABSTRACT Objective: To evaluate the functional result of arthroscopic treatment in anterosuperior rotator cuff tears. Methods: Fifty-six patients submitted to arthroscopic repair of anterosuperior rotator cuff tears were evaluated. The follow-up time was five year and five months. All the tears were diagnosed by detailed physical and imaging examination. Statistical analysis was used to compare the preoperative and postoperative results of range of motion and the UCLA score, with Wilcoxon signed-rank test, 5% significance level (p≤0.05), the relationship between the subscapularis tear and postoperative results using the Mann-Whitney test, and between the pain length and the UCLA scale using Spearman's correlation. Results: A statistically significant improvement (p<0.001) was found, comparing the range of motion and the UCLA preoperatively and postoperatively. 39% of the cases were classified as excellent, 33.9% as good, 23.7% as regular and 3.4% as bad results. A statistically significant relationship was found between the subscapularis tear type and the functional state, the pain length and the postoperative UCLA scale. Five complications, four reruptures and one adhesive capsulitis were found. Conclusions: The arthroscopic treatment for anterosuperior tears presented satisfactory results, with 8.5% of complications. Level of Evidence IV, Case series.

The development of β-metastable titanium alloys that combine low Young’s modulus, good mechanical properties, corrosion resistance and biocompatibility has attracted industry interest. This type of alloy is an alternative to commercial alloys such as Ti-6Al-4V, avoiding the cytotoxic effect that occurs with Al and V in the human body in the manufactured orthopedic prostheses. In this scenario, the present work aims to characterize the effect of Nb concentration in the properties of Ti alloys based on the Ti-12Mo-xNb stoichiometry (x = 0, 3, 8, 13, 17 and 20). All alloys were produced by arc melting with non-consumable tungsten electrode in an argon atmosphere and the ingots were characterized by x-ray diffraction (XRD), optical microscopy (OM), Vickers microhardness and Young’s modulus was measured by impulse excitation and density was measured using the Archimedes’ principle. The Ti-12Mo alloy and the Ti-12Mo-20Nb alloy showed the lowest Young’s modulus. The best hardness/modulus was found for the Ti-12Mo-3Nb alloy. All the alloys studied in this work showed hardness/modulus ratio above the traditional Ti-6Al- 4V alloy (2.85), presented great potential for the biomedical application.

RESUMO Objetivo: Avaliar os resultados da cirurgia artroscópica em pacientes com instabilidade traumática anterior do ombro. Métodos: Realizamos um estudo retrospectivo de 76 pacientes, com média etária de 28 anos e tempo médio de seguimento pós-operatório de 62 meses. A avaliação foi feita por meio de exame físico, radiográfico e classificação de resultados segundo as escalas funcionais da UCLA e Rowe. Resultados: Os pacientes apresentaram perda de amplitude de movimento em todos os planos, exceto elevação e rotação lateral em abdução de 90º. Na avaliação da escala de Rowe, observamos, em média, melhora estatisticamente significante dos resultados pós-operatórios comparadas às avaliações pré-operatórias, com 89,4% de resultados satisfatórios. Pela escala UCLA, observamos resultados satisfatórios em 97,4% dos casos. Encontramos um índice de recidiva de 6,5%. Conclusão: A cirurgia artroscópica para o tratamento da instabilidade traumática anterior do ombro é um método eficaz, desde que se respeitem as indicações. Nível de Evidência IV, Série de Casos.

ABSTRACT Objective: To evaluate the results of arthroscopic surgery in patients with traumatic anterior shoulder dislocation. Methods: This retrospective study analyzed 76 patients with a mean age of 28 and mean postoperative follow-up period of 62 months. Evaluation consisted of physical examination, and X-rays; results were classified according to the UCLA and Rowe scales. Results: Patients showed decrease of range of motion in all planes, except elevation and lateral rotation with 90º abduction. According to the Rowe score, significant postoperative improvement was found compared with preoperative evaluations, with 89.4% of satisfactory results. According to the UCLA score, good or excellent results were observed in 97.4% of the cases. We found a 6.5% rate of recurrence. Conclusion: Arthroscopic treatment for traumatic anterior shoulder dislocation is effective, as long as indications are used. Level of Evidence IV, Case Series.

Approximately thousand years ago it was reported the use of mandibles of ants for suture. In this sense, bioinspired components, as absorbable surgical clamps, can be designed. This study is aimed to characterize the mandible of the ant Atta laevigata in order to help the selection of candidate biomaterials for application as surgical clamps. Three pairs of mandibles were used and ten nanoindenations were performed in each pair. The average hardness for the samples in the internal and external regions were 0.36 ± 0.06 GPa and 0.19 ± 0.04 GPa, respectively and the average elastic modulus for the internal and external regions were 6.16 ± 0.23 GPa and 2.74 ± 0.44 GPa, respectively. The morphology of the mandible was observed in detail by scanning electron microscopy, as well as Energy-dispersive X-ray spectroscopy. The average roughnesses on the internal and external regions, measured by atomic force microscopy, were 6.73 ± 0.90 nm and 11.87 ± 1.42 nm, respectively. From these results, it was possible to identify biomaterials that mimic the mandible behaviour for surgical clamp.

2.25Cr-1Mo steels are widely used in thermoelectric power plants. Under operational temperatures, their properties degrade due to microstructural changes related to carbide coalescence and stoichiometric transformations. The extent of such microstructural changes is controlled by stress, temperature and time. Therefore, these factors can be used to evaluate damage and as life assessment tools for the individual component. In the past, ferrite-pearlite was the predominate microstructure in commercial Cr-Mo steel products, owing to the well-known methodologies for remaining life assessment based degradation. Currently, the ferrite-bainite microstructure obtained through a more economical route is most commonly used for this steel grade. However, there is no consensus in the literature about microstructural changes that can be used as a degradation pattern for ferrite-bainite steels. This paper compares the aged microstructures and creep properties of ferrite-pearlite and ferrite-bainite 2.25Cr-1Mo steels. Aging was conducted at 500, 575 and 600ºC until 2,000 h, and creep tests were performed at 575ºC under a stress of 100 MPa. Microstructural changes were characterized by optical microscopy scanning electron microscopy. Metallographic observations of the ferrite-bainite steel show a more stable behavior at the ageing temperatures and time considered. However, creep tests revealed that the ferrite-pearlite microstructure possesses a better rupture time performance. Carbide size distribution and stoichiometric evolution of the carbides provided by transmission electron microscopy support the creep behavior. These results show that the current techniques for evaluating microstructural degradation of 2.25Cr-1Mo steels must be reconsidered.

Metastable β-type Ti alloys with non-toxic addition elements such as Mo, Zr, Sn, Ta and Nb were developed as an alternative to the widely used Ti-6Al-4V alloy for biomedical applications. These alloys possess enhanced biocompatibility and reduced elastic modulus in comparison with Ti-6Al-4V. Moreover, for orthopedic implants, low Young's modulus is required in order to avoid the stress shielding phenomenon. This study analyzes the microstructure and mechanical properties of a new Ti-12Mo-8Nb alloy after hot swaging, annealing at 950 ºC for 1h and water quenching. The alloy was characterized by X-ray diffraction, optical microscopy and transmission electron microscopy. Tensile tests were performed at room temperature. Young's modulus and hardness values were also measured. The structural characterization reveals a metastable β structure containing only a small amount of α and ω phases. Exhibiting a lower Young's modulus than Ti-6Al-4V and other previously studied Ti-Mo-Nb alloys, the Ti-12Mo-8Nb alloy can be a promising alternative for orthopedic application.

Two distinct AISI type 316 stainless steels, of Brazilian and Swedish origins, were compared regarding their creep fracture mechanisms at 600, 700 and 800°C. The possible mechanisms associated with the creep fracture strength were identified by means of fracture maps proposed either by Ashby and collaborators or by Miller and Langdon. Experimental creep results were consistent with the general Ashby and collaborators map for face centered cubic alloys. By contrast, the two different 316 steel displayed significant differences in the model-based map of Miller and Langdon. In the present work, changes in the maps frontier are proposed as well as the introduction of a new field in the map related to grain boundary precipitation. These propositions allowed the Miller and Langdon map to be coherent with the experimental creep fracture results of both 316 stainless steels.

RESUMO Objetivou-se com este estudo avaliar o consumo e a digestibilidade aparente dos nutrientes em ovinos alimentados com sal forrageiro de faveleira (Cnidoscolus phyllacanthus) com níveis crescentes de cloreto de sódio na sua composição. Foram utilizados 25 carneiros, sem padrão racial definido, não castrados, alocados em baias individuais, distribuídos em um delineamento experimental inteiramente casualizado, com cinco tratamentos e cinco repetições. As dietas que continham 1, 3, 5 e 7% de cloreto de sódio na composição do sal forrageiro de faveleira foram oferecidas à vontade. Todos os tratamentos receberam feno de capim Tifton-85 moído como dieta basal e água à vontade. As dietas foram oferecidas duas vezes ao dia. Os níveis crescentes de cloreto de sódio no sal forrageiro de faveleira proporcionaram efeito significativo (P<0,05) sobre o consumo e a digestibilidade aparente da matéria seca, fibra em detergente neutro, proteína bruta, extrato etéreo, carboidratos não-fibrosos e nutrientes digestíveis totais, quando comparados com o tratamento controle. Recomenda-se a inclusão máxima de até 3% de cloreto de sódio na composição do sal forrageiro de faveleira, por proporcionar aumento no consumo da matéria seca. Todos os níveis testados proporcionaram aumento no consumo de proteína bruta, extrato etéreo e carboidratos não-fibrosos e também melhoraram a digestibilidade aparente de todos os parâmetros avaliados, quando comparados ao tratamento controle, contudo, o nível de 1% de inclusão de cloreto de sódio na formulação do sal forrageiro de faveleira apresentou melhor digestibilidade.

SUMMARY This study evaluated the intake and apparent digestibility of nutrients by sheep fed with fodder salt with faveleira (Cnidoscolus phyllacanthus), with increasing levels of sodium chloride in the preparation. Twenty five sheep, mongrel, not castrated, placed in individual cages, and distributed in a completely randomized design with five treatments and five replicates. Diets were offered the will containing 1, 3, 5 and 7% sodium chloride in the fodder salt. All animals also received grounded Tifton-85 hay (Cynodon sp) as basal diet abundant, and water abundant. All Diets were offered twice a day. Increasing levels of sodium chloride no fodder salt faveleira provided differences (P<0.05) on intake and apparent digestibility of dry matter, neutral detergent fiber, crude protein, ether extract, total digestible nutrients and non-fibrous carbohydrates, when compared to the control treatment. It is recommended maximum to include up to 3% of sodium chloride in the composition of forage salt faveleira, for providing improved intake of dry matter. All tested levels provided improvement inteke of crude protein, ether extract, and non-fiber carbohydrates and also improved the apparent digestibility of all parameters when compared to the control treatment, however, the level of 1% inclusion of sodium chloride in the fodder salt faveleira showed better digestibility.

ABSTRACT Objective: To evaluate the evolution of injuries of the supraspinatus muscle by immunohistochemistry (IHC) and anatomopathological analysis in animal model (Wistar rats). Methods: Twenty-five Wistar rats were submitted to complete injury of the supraspinatus tendon, then subsequently sacrificed in groups of five animals at the following periods: immediately after the injury, 24h after the injury, 48h after, 30 days after and three months after the injury. All groups underwent histological and IHC analysis. Results: Regarding vascular proliferation and inflammatory infiltrate, we found a statistically significant difference between groups 1(control group) and 2 (24h after injury). IHC analysis showed that expression of vascular endothelial growth factor (VEGF) showed a statistically significant difference between groups 1 and 2, and collagen type 1 (Col-1) evaluation presented a statistically significant difference between groups 1 and 4. Conclusion: We observed changes in the extracellular matrix components compatible with remodeling and healing. Remodeling is more intense 24h after injury. However, VEGF and Col-1 are substantially increased at 24h and 30 days after the injury, respectively. Level of Evidence I, Experimental Study.

β-metastable titanium alloys with high strength to Young’s modulus ratio have been developed by different authors aiming their use as biomaterials for hard tissue replacement. However, it is not easy to combine low elastic modulus with high mechanical strength. In this work, a β-Ti alloy (Ti-10Mo-20Nb) was produced by arc-melting, then homogenized, cold swaged and aged in order to obtain fine α-Ti precipitates in a β-Ti matrix. The microstructures were characterized by transmission electron microscopy and X-ray diffraction. Mechanical properties characterization was based on Vickers microhardness tests and Young’s modulus measurements. The cold swaged material subjected to an ageing treatment at 500 °C for 4 h showed the highest hardness/ Young’s modulus ratio, associated to very fine α phase precipitates in a β-Ti matrix.

Beta titanium alloys were developed for biomedical applications due to the combination of its mechanical properties including low elasticity modulus, high strength, fatigue resistance, good ductility and with excellent corrosion resistance. With this perspective a metastable beta titanium alloy Ti-12Mo-13Nb was developed with the replacement of both vanadium and aluminum from the traditional alloy Ti-6Al-4V. This paper presents the microstructure, mechanical properties of the Ti-12Mo-13Nb hot swaged and aged at 500 °C for 24 h under high vacuum and then water quenched. The alloy structure was characterized by X-ray diffraction and transmission electron microscopy. Tensile tests were carried out at room temperature. The results show a microstructure consisting of a fine dispersed α phase in a β matrix and good mechanical properties including low elastic modulus. The results indicate that Ti-12Mo-13Nb alloy can be a promising alternative for biomedical application.

Objective: To determine the distance between the axillary nerve and the antero-lateral (AL) edge of the acromion, its anatomical variability and relationship to humeral length and body height.Methods: Twenty-two shoulders were dissected. The anterosuperior (AS) approach was used; the deltoid was detached from the acromion and the distance between the AL portion and the axillary nerve was measured and submitted to statistical analysis.Results: The distance varied from 4.3 to 6.4 cm (average 5.32 ± 0.60 cm). The axillary nerve distance increased as the humeral size (p<0.05) and the height of each cadaver increased. However, the correlation with the specimens height was not significant (p=0.24).Conclusions: The distance between the acromion and the axillary nerve on the AS approach was 5.32 ± 0.60 cm in both shoulders, and increasing the humeral length there is also an increase in the axillary nerve distance. Level of Evidence IV, Case Series - Anatomic Study.

OBJETIVOS: Avaliar os resultados clínico-funcionais dos pacientes com lesão extensa do manguito rotador submetidos ao reparo artroscópico pela técnica de convergência de margens da parte posterior do manguito rotador com o tendão da cabeça longa do músculo bíceps braquial. MÉTODOS: Vinte casos de lesões extensas do manguito rotador, que tinham lesão do tendão supraespinal retraído e deficiência do intervalo rotador, foram operados em nosso serviço com essa técnica. Dezesseis casos eram do sexo feminino (80%) e quatro do sexo masculino (20%); média da idade de 58,95 anos (42 a 75 anos). Em 16 casos a lesão havia ocorrido no membro dominante (80%). Em todos os pacientes o movimento de elevação, rotação medial e lateral, assim como a pontuação pela escala da UCLA, foram documentados no período pré-operatório. Todos foram reavaliados com o mínimo de dois anos de acompanhamento, sendo estudadas a pontuação da escala funcional da UCLA e a mobilidade. RESULTADOS: A pontuação da escala funcional da UCLA no período pós-operatório foi em média de 28,95 pontos, com acréscimo de 13,9 pontos, uma melhoria estatisticamente significativa (p < 0,001). Seis casos foram classificados como excelentes, nove bons, três regulares e dois ruins. Houve uma melhoria do arco de movimento com aumento médio da elevação de 117,62 para 151,19 (p < 0,001), rotação lateral de 47,38 para 50,48 (p < 0,396) e rotação medial de L2 para T12 (p < 0,025). CONCLUSÃO: Neste estudo a técnica cirúrgica apresentada levou a uma melhoria da função e mobilidade do ombro com valores estatisticamente significantes.

OBJECTIVES: To assess the outcomes of the arthroscopic margin convergence of the posterior cuff to the biceps tendon. METHODS: From October 2003 to December 2007, 20 patients with massive rotator cuff tear which include the rotator interval were treated with arthroscopic margin convergence of the posterior cuff to biceps tendon. Sixteen patients were female and four were male. The mean age was 58.95 years old. The dominant side was affected in 16 cases (80%). The outcomes were analysed according to the UCLA Score with a minimum follow-up period of two years. RESULTS: The UCLA score improved, on average, 14 points (p < 0.001). Six patients had excellent results; nine good; three fair and two poor results. The mean improvement of forward flexion was 33º (p < 0.001), 3º of external rotation (p < 0.396) and two vertebral levels for internal rotation (p < 0.025). CONCLUSION: The arthroscopic margin convergence of the posterior cuff to the biceps tendon leads to satisfactory results.