CE is safe in pediatric patients over 12 years of age. The procedure appears to be a very useful diagnostic tool in children with Crohn's disease.

Background:Despite the increasing incidence of sports-related knee injuries in youth athletes, few studies have reported on the diagnosis and treatment of pediatric and adolescent meniscal root injuries.Purpose:To describe traumatic posterior meniscal root injuries in a pediatric and adolescent population and compare the presentation of meniscal root injuries versus that of nonroot injuries.Study Design:Cohort study; Level of evidence, 3.Methods:A study was conducted of all knee arthroscopies performed on consecutive patients treated in a pediatric sports practice from March 2012 through February 2015. All patients who were younger than 20 years at the time of their injury and who underwent an arthroscopy with meniscal injury were included. Patients with discoid lateral meniscus, atraumatic meniscal cysts, partial-thickness meniscal root injuries (LaPrade type 1), and recurrent root tears were excluded. A comparative analysis of root and nonroot injuries was performed.Results:A total of 314 patients had surgery for meniscal injury (mean patient age, 16.0 years; range, 10.5-19.6 years). Of these patients, 58 (18.5%) posterior meniscal root injuries were identified. The root injuries were more likely to have joint line tenderness on preliminary physical examination compared with nonroot injuries (96.5% vs 58.6%, respectively; P < .001). Root injuries rarely occurred in isolation compared with nonroot meniscal tears (6.9% vs 17.6%; P = .021) and were frequently treated in combination with anterior cruciate ligament (ACL) injuries (86.2%). Lateral root injuries occurred more often in conjunction with ACL injuries compared with medial root injuries (84.8% vs 22.2%; P < .001). On review of preoperative imaging, meniscal extrusion occurred more often in root injuries than in nonroot injuries (32.8% vs 3.5%; P < .0001) and was uncommonly seen in the skeletally immature patient. Extrusion was seen more often in medial than lateral root tears (66.7% vs 21.7%; P = .008). A majority of patients (57/58) underwent transosseous suture repair of the meniscal root.Conclusion:When treating a pediatric or adolescent patient for a traumatic meniscal tear, a surgeon may expect to see a posterior meniscal root injury in as many as 1 in 6 patients. When treated for an ACL, contact, or multiligament injury or meniscal extrusion, a pediatric or adolescent patient may demonstrate a meniscal root avulsion or complex meniscal tear. These data provide practitioners with an improved ability to identify and treat meniscal root injuries that otherwise lead to rapid cartilage degeneration.

We report a case of dislocation of the polyethylene inlay in revision total knee arthroplasty. Eight days after revision arthroplasty due to a previous infection, the polyethylene inlay of a PCL- retaining cemented total knee arthroplasty dislocated at about 80 degrees of flexion on the CPM machine. Lateral X-ray examination revealed an anterior slope of the tibial cut of 5 degrees. Correction of the tibial slope to a posterior tibial slope of 7 degrees reduced the forces on the posterior aspect of the inlay and no redislocation occurred. The mechanisms causing tibial inlays to dislocate in TKA are analyzed and discussed.

Four restored wetlands dominated by Phragmites australis, Typha latifolia and Scirpus lacustris were used to improve the quality of agricultural runoff in the Delta of the Ebro River (NE Spain) in 1993. The wetlands were continuously flooded with water from a ricefield irrigation network during the growing season and received water with between 0-270 mg m−2d−1 of total nitrogen, 29-105 mg m−2d−1 of dissolved inorganic nitrogen and 0-27 mg m−2d−1 of dissolved organic nitrogen. Surface outflows contained between 0-80 mg m−2d−1 of total nitrogen, 0-12 mg m−2d−1 of dissolved inorganic nitrogen and 1-19 mg m−2d−1 of dissolved organic nitrogen. The nitrogen retention efficiency was close to 100% of the input, except for dissolved organic nitrogen at the end of the growing season. The denitrification rates measured by the acetylene reduction in the sediment ranged between 0 and 3.46 mg N m−2 d−1 and represented between 0 and 12% of the inflowing dissolved inorganic nitrogen. Emergent macrophytes accumulated between 20 and 100 mg N m−2 d−1, which accounts for between 66 and 100% of the inflowing dissolved inorganic nitrogen. The wetland sediment accumulated between 111 and 250 mg N m−2 d−1 during the six month growing season. The removal rate constants calculated according to a first - order plug - flow kinetics, were between 0.01-0.075 m d−1 for total nitrogen and 0.01-0.3 m d−1 for dissolved inorganic nitrogen. Plant uptake, detritus accumulation and decomposition, and nitrogen recycling in the sediment are major processes for nitrogen retention and recycling in the wetlands. This type of wetlands, restored from ricefields, act as highly efficient water polishing filters for agricultural runoff and, at the same time, can contribute to increase the habitat biodiversity of large areas where rice is cultivated extensively.

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