Hip osteochondral lesions: arthroscopic evaluation.

BACKGROUND: Hip arthroscopy has allowed the diagnosis and treatment of chondral injuries. METHODS: We retrospectively analysed the intraoperative data of 359 patients treated with hip arthroscopy from January 2012 to December 2013. We estimated the frequency, location and extension of acetabular cartilage (AC) injuries and their correlation to femoroacetabular impingement (FAI). RESULTS: Grade 1 and 2 acetabular chondral lesions were not statistically significant in incidence, location and extension. Chondral lesions were absent on the acetabulum in 3.9% of cases, significantly lower compared to the femoral head (32.0%). 101 (28.1%) were affected by an acetabular chondral lesion. In 244 (68.0%) the chondral lesion was located on both acetabulum and femoral head. On the acetabulum, peripheral superior and superior-posterior area were frequently involved. Grade 4 acetabular chondral defects showed a significant high location on the superior-anterior, superior and superior-posterior area, involving both the peripheral and central surface. Delamination was present in 113 (31.5%) patients. Patients affected by acetabular delamination showed a reduced injury extension if compared to grade 3 or 4. 81 patients (25%) revealed acetabular chondral lesions grade 2a, 3 and 4 without any radiological, clinical or arthroscopic sign of FAI. CONCLUSIONS: Location, extension and degree of hip chondral lesions show a progression toward a progressive degeneration. The high percentage of chondral delamination in the hip must be taken in consideration. The presence of symptomatic chondral lesion in cases with no radiological evidence of FAI, suggests that their aetiopathogenesis could be related to biomechanical alterations.

Identification of the main venom protein components of Aphidius ervi, a parasitoid wasp of the aphid model Acyrthosiphon pisum.

BACKGROUND: Endoparasitoid wasps are important natural enemies of the widely distributed aphid pests and are mainly used as biological control agents. However, despite the increased interest on aphid interaction networks, only sparse information is available on the factors used by parasitoids to modulate the aphid physiology. Our aim was here to identify the major protein components of the venom injected at oviposition by Aphidius ervi to ensure successful development in its aphid host, Acyrthosiphon pisum. RESULTS: A combined large-scale transcriptomic and proteomic approach allowed us to identify 16 putative venom proteins among which three γ-glutamyl transpeptidases (γ-GTs) were by far the most abundant. Two of the γ-GTs most likely correspond to alleles of the same gene, with one of these alleles previously described as involved in host castration. The third γ-GT was only distantly related to the others and may not be functional owing to the presence of mutations in the active site. Among the other abundant proteins in the venom, several were unique to A. ervi such as the molecular chaperone endoplasmin possibly involved in protecting proteins during their secretion and transport in the host. Abundant transcripts encoding three secreted cystein-rich toxin-like peptides whose function remains to be explored were also identified. CONCLUSIONS: Our data further support the role of γ-GTs as key players in A. ervi success on aphid hosts. However, they also evidence that this wasp venom is a complex fluid that contains diverse, more or less specific, protein components. Their characterization will undoubtedly help deciphering parasitoid-aphid and parasitoid-aphid-symbiont interactions. Finally, this study also shed light on the quick evolution of venom components through processes such as duplication and convergent recruitment of virulence factors between unrelated organisms.

Five-year results of arthroscopic techniques for the treatment of acetabular chondral lesions in femoroacetabular impingement.

PURPOSE: This study assesses and compares the clinical outcomes of the arthroscopic matrix-induced autologous chondrocyte implant (MACI) and autologous matrix-induced chondrogenesis (AMIC) techniques for the treatment of acetabular chondral defects between 2 and 4 cm(2) consequent to femoral acetabular impingement. METHODS: Fifty-seven consecutive patients were treated with the MACI (n = 26) or AMIC (n = 31) technique. Patients were assessed pre-operatively and up to five years using the modified Harris Hip Score (mHHS) to compare outcomes. RESULTS: In both the MACI and AMIC groups, significant hip score improvements were measured over baseline levels at six months post-op (81.2 ± 8.4 for MACI, 80.3 ± 8.3 for AMIC, both p < 0.001). The mHHS continued to improve up to three years post-op and remained stable over time until the final five year follow-up. Statistically significant differences between the groups were not observed. The mean mHHS improvement at the five year follow-up with respect to preoperative level was 37.8 ± 5.9 and 39.1 ± 5.9 in patients who underwent MACI and AMIC, respectively (NS). Subgroup analysis of both MACI and AMIC treatment outcomes for patients with an initial chondral defect larger than 3 cm(2) yielded comparable results at each time point. CONCLUSIONS: This study suggests that both arthroscopic MACI and AMIC are valid procedures to repair medium-sized chondral defects on the acetabular side of the hip found during treatment of femoroacetabular impingement. Due to its high sustainability and minimal invasiveness, the single-stage AMIC procedure can reduce total treatment time and minimise morbidity while providing the same beneficial effects as the two-stage MACI intervention.