Objectives: Previous reports regarding arthroscopic management of dysplastic hip morphologies have conflicting results. Arthroscopy alone in the setting of dysplastic morphologies is controversial. Methods: We retrospectively reviewed 88 hips (77 patients, 71% female, mean age 33.9 years) with radiographic findings consistent with hip dysplasia and a mean 26.0 months follow-up (range 12-80 months) after hip arthroscopy. Procedures performed included 67 labral repairs (76%), 20 selective labral debridements (23%), 72 capsular repair / plications (82%), and management of associated cam-type morphology in 63 hips (72%). All radiographs were evaluated for parameters consistent with dysplasia including the LCE, Neck Shaft angle, Tonnis angle, Extrusion index, femoral head lateralization, and break in Shenton's line. Preoperative and post-operative function were evaluated prospectively using the Modified Harris Hip Score (MHHS), SF-12 scoring, and pain on a visual analog score (VAS). Patient demographics, procedures performed, and radiographic parameters were evaluated with regards to functional outcomes. In addition, the results of the dysplastic cohort were compared to an aged matched cohort of 231 hips (215 patients, 52% female, mean age 32 years) performed during the study period with a mean follow-up 22.7 months (12-60 months) that underwent arthroscopic FAI correction without the diagnosis of dysplasia. Results: The mean LCE was 20.8 degrees (range, 8.7 -24.5), and mean Tonnis angle was 11.0 (range, 0 -22.2 degrees). The dysplastic cohort had a mean latest MHHS of 81.3 (range, 34-100) and mean 15.6 point (range, -28 -60) improvement in MHHS compared to 88.4 points and 24.4 points, respectively, in the FAI cohort (p<0.01). The dysplastic cohort had 60.9% good to excellent results and 32.2% failures, compared to 81.2% good/excellent results and 10.5% failures for the FAI cohort (p<0.01). Decreased head neck offset (cam-type morphology) trended towards being predictive of better scores in the dysplastic cohort (p=0.079). In addition, dysplastic hips that underwent capsular plications and labral repairs had greater good / excellent results and lower failure rates (p>0.05). Grade 4 chondral defects were predictive of lower scores (p=0.02). There were no statistically significant differences for functional outcomes regarding gender or age for either cohort (p>0.05). There were no iatrogenic subluxations / dislocations in either group. Conclusion: Although functional scores were improved post-arthroscopy in hips with mild to borderline dysplastic morphologies, Good/Excellent results were inferior and Failure rates were higher compared to an FAI cohort. These results were independent of gender. Associated cam-type FAI, and labral repair / capsular plications were predictive of better clinical outcomes in the dysplastic cohort. Outcomes after pelvic osteotomy in this borderline population are required to determine the optimal treatment.

Changes in plant traits induced by herbivore damage can produce a negative feedback to increasing herbivore densities. Several aspects of these plant-mediated feedbacks are predicted to influence herbivore population dynamics, but the degree to which feedbacks are non-linear, whether their strength varies among plant genotypes, and whether they occur via changes in the quality of plant tissue or the amount of tissue available have rarely been examined. In this study, we damaged five genotypes of the perennial weed Carolina horsenettle, Solanum carolinense L. (Solanaceae), with eight densities of the false potato beetle, Leptinotarsa juncta (Germar) (Coleoptera: Chysomelidae, Chrysomelini). To account for plant quantity available to beetles, we measured the leaf area of each plant after imposing larval density treatments. We then measured the oviposition preference of L. juncta adults for damaged vs. undamaged plants and the relative growth rate (RGR) of L. juncta larvae on each plant, as well as plant trypsin proteinase inhibitor (tryPI) expression. We found that L. juncta females strongly preferred to oviposit on undamaged S. carolinense, and that preference for a plant decreased as the density of damaging larvae increased. In addition, we found decreased larval RGR and increased production of tryPIs with greater initial larval density. Effects of larval density on insect preference, performance, and tryPI expression were linear and did not vary among plant genotypes. Larval density effects were not solely due to reduced plant quantity, as plant leaf area had no effect on oviposition preference or larval performance. This suggests that effects were most likely due to changes in the quality of plant tissue. Thus, negative feedback on increasing larval density can be mediated by the effects of induced resistance on both oviposition preference and larval performance. Published models suggest that the linear, quality-mediated feedbacks observed in this experiment are predicted to stabilize herbivore population dynamics.

Objectives: There is very little published literature looking at comprehensive complication rates after hip arthroscopy with current techniques and indications. Methods: Between 01/2011 and 11/2012, 1,026 consecutive hips (507 males, 519 females) with a mean age of 31.2 years (range 12 -73) underwent hip arthroscopy at three institutions. The diagnosis, demographic information, and procedures were recorded, and a validated complications grading classification for hip joint surgery (Clavian classification) was utilized for all patients prospectively. Results: There were 951 primary hip arthroscopies and 75 revision hip arthroscopies. Arthroscopy was performed for FAI in 936 hips (91.2%), and 760 hips (74.1%) had a labral repair and 229 hips (22.3%) had a labral debridement. The most common event (18.7% of hips) noted was post-operative sensory disturbance adjacent to the portals or involving the distal anterolateral thigh consistent with LFC nerve disturbance. This was typically not noticed by patients and found on physical examination and only persisted beyond 6 months in 7 hips (0.7%). Iatrogenic chondral injury was noted for 20 hips (1.9%), iatrogenic labral puncture in 11 hips (1.1%), superficial portal infection in 6 hips (0.6%), sensory deficit about the foot in 9 hips (0.9%), deep venous thrombosis in 3 hips (0.3%), pulminary embolism in 1 hip (0.1%), pulmonary edema in 1 hip (0.1%), wound hematoma in 2 hips (0.2%), perineal numbness (pudendal nerve) in 9 hips (0.9%), heterotopic ossification in 4 hips (0.4%), reflex sympathetic dystrophy in 1 hip (0.1%) and wound/skin (traction) dehiscence in 1 hips (0.1%). There were no femoral neck fractures, iatrogenic instability, AVN, or extra-abdominal fluid extravasation in this cohort. The overall complication rate not including temporary periportal and thigh numbness (sequalae) was 6.9% (71 hips). Overall 88.7% had a grade 1, 5.6% Grade 2, 4.2% grade 3, and 1.4% grade 4 complication. There was no difference in the rate of complications between males and females (p=.221), primary vs revision cases (p=.159) or labral repair vs debridement (p=.173), and BMI had no effect on complication rate. Conclusion: The overall complication rate after hip arthroscopy was 6.9% and higher than previously reported in the literature. This rate of complications is in line with complication rates after open surgical dislocation using the same classification system.

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