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At least 19 recordsLinked to original sources
PubMed1996

Total knee replacement infection after 2-stage reimplantation: results of subsequent 2-stage reimplantation.

Twelve patients who underwent salvage of an infected total knee replacement with removal, debridement, 6 weeks of parenteral antibiotics, and reimplantation subsequently acquired another infection in the same knee. These patients were again treated with the same protocol followed by reimplantation or arthrodesis and were observed for an average of 31 months. Nine of the patients underwent reimplantation surgery and 3 of the patients underwent arthrodesis. At followup the average Hospital for Special Surgery knee score for the reimplantation group was 84, the average Knee Society knee score was 79, and the average functional score was 73. The 3 patients who did not undergo reimplantation surgery had solid fusions in good position but were dissatisfied with their stiff limb. No knee to date has shown signs of recurrent infection.

Aged↗
PubMed1987

[Surgical results of uretero-vesical reimplantations in children. Apropos of 356 cases in 11 years (629 reimplanted ureters)].

629 ureteric reimplantations were performed in 356 children. Indications for reimplantation were 315 uni or bilateral ureteral reflux, 248 primary reflux and 67 secondary to ureteric duplication, ureterocele, vesical diverticula, neurogenic bladder, bladder neck obstruction, or ureteral obstruction, and 52 megaureters, 38 primary and 14 secondary megaureters. 61 reimplantations (14 megaureters) by Leadbetter-Politano, and 568 reimplantations (58 megaureters) by Cohen procedure were performed. 3 psoas hitching and 15 ureteroplasties, 14 Hendren and 1 Kalicinski procedures, were necessary. Primary results in reflux were 98.5% of success with Cohen operation and 100% with Leadbetter-Politano operation. Results were not so good in megaureter, 70% of success with Leadbetter-Politano operation and 75% with Cohen. Results were better with psoas hitching and ureteroplasty (86.5% of success).

Adolescent↗
PubMed1987

[Microsurgical treatment of lesions of the proximal segment of the oviduct. Isthmo-ostial reimplantation. Isthmo-ostial anastomosis and isthmo-uterine reimplantation].

The authors, who operated on 187 patients with 277 interstitial sections of the isthmus, describe their microsurgical techniques for isthmo-ostial anastomosis, for isthmo-ostial reimplantation and for isthmo-uterine reimplantation. Histological analysis of the lesions and the anatomical features of the proximal segment of the tube justify their method. Patency is re-established and the results are encouraging. All the same, these partial proximal lesions can be markedly improved with success by medical treatment before operation.

Fallopian Tube Diseases↗
PubMed1987

Reimplantation of autologous septal cartilage in the growing nasal septum. I. The influence of resection and reimplantation of septal cartilage upon nasal growth: an experimental study in rabbits.

The effects of restoration of the dorso-ventral continuity of the nasal septum on the growth of the nose was investigated in growing rabbits. Submucous resection of the middle third of the septal cartilage resulted in characteristic growth disturbances of nose and maxilla. Reimplantation of the resected strip of autologous cartilage did not restore the normal development of the nose. The implants however did prevent septal perforations as seen after resection of cartilage only and showed a considerable growth in dorso-ventral direction.

Animals↗
PubMed1988

Reimplantation of autologous septal cartilage in the growing nasal septum. II. The influence of reimplantation of rotated or crushed autologous septal cartilage on nasal growth: an experimental study in growing rabbits.

A series of experiments were carried out on growing rabbits to investigate the effect of rotation (through 90 degrees and 180 degrees) or crushing of autologous cartilage implants on growth of the nose. Reconstruction of the nasal septum with rotated or crushed implants did not restore the normal growth of the nose. This is in accordance with the results of a previously described experiment in which the continuity was repaired with autologous cartilage in the same position (Nolst Trenité et al., 1987). The crushed cartilage implants were as effective as the noncrushed implants in preventing septal perforations. The implants rotated through 90 degrees, showed less intrinsic growth in dorso-ventral direction.

Animals↗
PubMed1975

Readjustment of retinotectal projection following reimplantation of a rotated or inverted tectal tissue in adult goldfish.

1. The pattern of visual projection from the retina on to the optic tectum following reimplantation of a piece of the tectal tissue was studied with neurophysiological mapping methods in adult goldfish. 2. When a rectangular piece of the tectum was dissected, lifted free, and then reimplanted to the same tectum after rotation by 180 degrees around the dorsoventral axis, the re-established visual projection later showed a complete reversal of retinotopic order within the reimplanted area with reference to the normal projection on to the intact surrounding area of the same tectum. The localized reversal was observed as early as 65 days, and also as late as 721 days after the 180 degree rotated reimplantation. 3. If a square piece of the tectal tissue was reimplanted after rotation by 90 degrees anticlockwise around the dorsoventral axis, the restored visual projection later showed a corresponding localized 90 degrees rotation within the reimplanted ares. 4. When the entire laminar structure of a dissected tectal tissue was inverted, and the reimplanted upside-down along the same rostrocaudal axis of the tectum, the restored visual projection on to the inverted tectal reimplant was found to be organized in a reverse retinotopic order along only the mediolateral axis within the reimplanted area. The restored visual projection retained a correct retinotopic order along the rostrocaudal axis. The same trends were also observed after regeneration of the optic fibres following section of the contralateral optic nerve. 5. If the inverted tectal tissue was reimplanted along the same mediolateral axis of the tectum, the re-established visual projection showed a localized reversal of retinotopic order along only the rostrocaudal axis within the reimplanted area. Sectioning the contralateral optic nerve made no difference to the result. 6. These results suggest that a piece of adult tectal tissue retains its original topographic polarity regardless of the orientation of reimplantation after either a rotation or an inversion. Furthermore the retention is not a short-lived transitory phenomenon. It persisted as long as the reimplanted tissue survived. 7. Histological examination of the operated tecta revealed that the reimplanted tectal tissues underwent a severe derangement in their laminar structures. It was impossible to identify the main target zone of retinotectal projection (the stratum fibrosum et griseum superficiale) or the central cellular layer (the stratum griseum centrale) in the reimplants. The prominent feature of the deranged tectal tissue was irregular vortices of tangled fibre bundles. Sparse tectal neurones of bipolar and granular types were irregularly scattered in the deranged structure of the reimplant. 8. Thus, the retention of original topographic polarity did not require an integrity of the cytoarchitectonic structure of the reimplanted tectal tissue.

Action Potentials↗
PubMed1977

Induction of compression in the re-established visual projections on to a rotated tectal reimplant that retains its original topographic polarity within the halved optic tectum of adult goldfish.

1. The topographic pattern of re-established retinotectal projections following various surgical manipulations of the optic tectum was studied in adult goldfish with neurophysiological mapping methods. 2. Immediately following excision of the caudal half of the tectum, a piece of the tectal tissue was dissected from the remaining rostral half-tectum, and then reimplanted to the same half-tectum after either 180 or 90 degrees anticlockwise rotation around the dorsoventral axis in the first experimental group. 3. A majority (twenty-one out of twenty-three) of these operated fish, in which the reimplanted tectal tissue degenerated, showed no sign of a field compression: only the nasal half of the visual field (with a localized partial scotoma corresponding to the area of the degenerated reimplant) projected on to the remaining intact area of the rostral half-tectum. 4. In seven fish, the re-established visual projections on to the 180 or 90 degrees rotated reimplants showed a corresponding localized 180 or 90 degrees rotation with reference to the other projections on to the surrounding intact area of the same half-tectum. Only one of these seven fish showed also a compression in the re-established projections from the entire visual field on to the operated half-tectum with the 90 degrees rotated reimplant. 5. When a field compression was induced first in the intact rostral half-tectum following excision of the caudal half, and then a piece of the 90 degrees rotated tectal tissue was reimplanted later within the rostral half-tectum, the previously induced field compression persisted, regardless of whether the reimplanted tissue degenerated or survived. In the latter case, the compression in the re-established visual projections on to the surviving reimplant occurred according to the original topographic polarity of the 90 degrees rotated tectal tissue. 6. A field compression could also be induced within a rotated tectal reimplant, which retained its original polarity, as follows. A piece of the tectal tissue was dissected from the central area of the whole tectum, and then reimplanted after either 180 or 90 degrees rotation. When the reimplanted tectal tissue became reinnervated later, the caudal half of the operated tectum (including the posterior half of the reimplant) was excised. The re-established visual projections on to the remaining part of the halved reimplant within the rostral half-tectum showed later a field compression in accordance with the original topographic polarity of the 180 or 90 degrees rotated tectal tissue. 7. These results provide direct evidence for the compatibility between the retention of original topographic polarity by a reimplanted tectal tissue and the capability of the same tectal tissue to readjust to a disparity in size. 8. Histological examination of the operated half-tectum with a reimplant, stained by a modified rapid Golai method, revealed that the reimplanted tectal tissues retained highly organized cytoarchitectonic structures...

Animals↗
PubMed2004

Aortic root surgery in Marfan syndrome: Comparison of aortic valve-sparing reimplantation versus composite grafting.

OBJECTIVE: The objective of this study was to compare the results of aortic valve-sparing reimplantation and aortic root replacement with mechanical valve conduits in patients with Marfan syndrome undergoing operation for aortic root aneurysms. Patients and methods Between March 1979 and April 2002, 119 patients with clinical evidence of Marfan syndrome underwent composite graft replacement with mechanical valve conduits (n = 74) or aortic valve-sparing reimplantation according to David (n = 45). The underlying causes were aortic dissection type A (43 patients) and aneurysms (76 patients). RESULTS: Patients undergoing aortic valve reimplantation were younger compared with patients undergoing composite grafting (28 vs 35 years, P =.002) and had longer intraoperative aortic crossclamp times (125 vs 78 minutes, P <.0001) and extracorporeal circulation times (162 vs 124 minutes, P <.0001). Early postoperative mortality was 6.8% (n = 5) in patients undergoing composite grafting and 0% in patients undergoing aortic valve reimplantation (P =.15). Mean follow-up was 30 months for patients undergoing aortic valve reimplantation and 114 months for patients undergoing composite grafting. Freedom from reoperation and death after 5 years postoperatively was 92% and 89% in patients undergoing composite grafting and 84% and 96% in patients undergoing aortic valve reimplantation (P =.31; P =.54), respectively. Thromboembolic complications or late postoperative bleeding occurred in 17 patients undergoing composite grafting, and an early postoperative event occurred in 1 patient undergoing aortic valve reimplantation. CONCLUSIONS: The results of aortic valve reimplantation and composite grafting of the aortic valve and ascending aorta with mechanical valve conduits are similar with regard to early and mid-term postoperative mortality and to the incidence of late reoperations in patients with Marfan syndrome. The low risk of thromboembolic or bleeding complications favors aortic valve reimplantation in these patients.

Adolescent↗
PubMed1997

Voiding cystourethrography after uncomplicated ureteral reimplantation in children: is it necessary?

PURPOSE: Our aim was to assess whether a voiding cystourethrogram after uncomplicated ureteral reimplantation is necessary or cost-efficient. MATERIALS AND METHODS: We retrospectively reviewed the records of patients who underwent uncomplicated reimplantation at our institution from 1988 to 1994. We also reviewed the literature to tabulate the reflux resolution rate from all published series of more than 100 ureters reimplanted. RESULTS: At our institution 119 patients (207 ureters) underwent uncomplicated reimplantation and a postoperative voiding cystourethrogram, which documented a 98.6% initial reflux resolution rate. All persistent postoperative reflux resolved spontaneously without treatment for a final resolution rate of 100%. We reviewed 1,494 abstracts using vesicoureteral reflux as a key word and found 19 series of more than 100 ureters reimplanted. The combined results of our series and those 19 from the literature revealed 3,346 patients (5,008 ureters reimplanted). The final reflux resolution rate was 98.58%. Series that included and excluded secondary vesicoureteral reflux documented final reflux resolution rates of 98.4 and 99.04%, respectively. Reflux resolved spontaneously in 85% of the ureters in which it was noted on the initial postoperative cystogram. At our institution the cost of a voiding cystourethrogram is $610 and we perform an average of approximately 20 uncomplicated reimplantations per year. In the United States there are approximately 230 pediatric urologists. If each surgeon performed 20 reimplantations per year at the same cost per voiding cystourethrogram, a cost savings of $2.8 million per year would result if the study were not performed after surgery. CONCLUSIONS: In the hands of experienced pediatric urologists uncomplicated ureteral reimplantation has a success rate of 99.04%. The yield of postoperative voiding cystourethrography is exceedingly low and a cost savings of $2.8 million per year would result by omitting the postoperative voiding cystourethrogram.

Adolescent↗
PubMed1999

Cochlear reimplantation.

OBJECTIVE: A small number of multichannel cochlear implant (CI) recipients require reimplantation. This study describes the causes of failure, surgical technique, and hearing outcomes in a consecutive series of 16 patients undergoing reimplantation of multichannel devices. We hypothesize that reimplantation is safe and that hearing results are at least as good as those measured following primary implantation. STUDY DESIGN: Retrospective analysis of consecutive clinical series. METHODS: Chart analysis of 191 consecutive CI operations performed at the University of Miami Ear Institute between 1990 and 1997 revealed 16 patients who received a second multichannel device. All but one had a minimum follow-up of 1 year after reimplantation. Ten of these patients had initial implantation performed by us, and six were initially operated on elsewhere. Main outcomes of the initial procedure were compared with those of the reimplantation, including electrode insertion length, number of channels programmed, and audiometric results. In addition, cause of failure and relevant surgical findings at the second procedure are described. RESULTS: There were no surgical complications after reimplantation surgery. Device failure was the most frequent cause for reimplantation. Time between initial implantation and failure ranged from 0 to 46 months (mean, 22.4 mo; median, 23 mo). Common intraoperative findings include mastoid fibrosis, bone growth at the cochleostomy, and skin flap breakdown. Following reimplantation, mean length of insertion, number of channels actively programmed, and speech recognition scores were at least as good as findings before initial implant failure. CONCLUSION: CI reimplantation is safe and effective.

Adolescent↗
PubMed1999

Muco-gingival and periodontal health recovery following reimplantation of teeth.

Reimplantation of avulsed permanent teeth following traumatic injuries is a widely accepted therapeutic measure; however, though periodontal healing is considered to be the major determinant of long-term survival of reimplanted teeth, the mucogingival reaction to reimplantation has never been assessed. In the present study, hygiene level and gingival inflammation of 13 reimplanted teeth were assessed according to the plaque index (PI) and the gingival index (GI) around both reimplanted and control teeth. The periodontal condition was evaluated by measuring probing depth and probing attachment level at the same location. The clinical parameters of the reimplanted teeth were compared with those of contralateral teeth with the help of the non-parametric Wilcoxon signed ranks test. There were no statistically significant differences in PI and GI scores at any points of measurements around both reimplanted and control teeth; neither did probing depths and probing attachment levels differ between reimplanted and contralateral teeth. The results of the present study indicated that the muco-gingival reaction following traumatic avulsion did not affect the long-term prognosis of the reimplanted teeth.

Adolescent↗
PubMed1996

Reinnervation of avulsed and reimplanted ventral rootlets in the cervical spinal cord of the cat.

Spinal nerve root avulsions frequently occur in brachial plexus injuries caused by traction. Such lesions are considered to afflict the central nervous system (CNS) and are, therefore, believed to be beyond surgical repair. The present experimental study was initiated to challenge this hypothesis. The ventral rootlets of C-7 were avulsed from the spinal cord in 28 cats via an anterior approach and subsequently reimplanted into the cord at the site of origin. In nonoperated control cats and cats undergoing reimplantation, electrophysiological experiments were performed and horseradish peroxidase was administered to the spinal nerve on the reimplanted side after survival times ranging from 6 to 293 days. Spinal cord sections in all cats were stained for neurofilament, acetylcholinesterase (AChE), Nissl, and glial fibrillary acidic protein. Horseradish peroxidase-labeled ventral horn motoneurons were found as early as 14 days after reimplantation and their number increased with time. On Days 209 and 293, the number of labeled neurons equaled the number of labeled ventral horn neurons in the two control cats that did not undergo surgery. Starting on Day 6 after reimplantation, the appearance of the ventral horn and the white matter in the neurofilament, AChE, and Nissl-stained sections changed as a result of the CNS response to the injury. A return to their normal appearance could be observed in these stainings from Day 209 onward. Glial fibrillary acidic protein-positive astrocytic tissue was consistently found in the ventral horn and in the white matter reimplantation area. From Day 69 onward, electrophysiological stimulation of the spinal nerve C-7 on the reimplanted side elicited an electromyogram response in the spinodeltoid muscle. The latency and threshold intensity of the C-7 responses were initially increased but equalized to match the nonoperated controls between 98 and 122 days after reimplantation. The results of this study show that functional regeneration of ventral horn neurons after root avulsion and subsequent reimplantation in the cat is possible.

Acetylcholinesterase↗
PubMed2001

Extravesical ureteral reimplantations for the correction of primary reflux can be done as outpatient procedures.

PURPOSE: Extravesical ureteral reimplantations are thought to be less morbid compared with traditional intravesical techniques. We believe a shorter length of stay can be achieved in children undergoing extravesical reimplantation for the correction of primary reflux without experiencing a reduction in quality of care. MATERIALS AND METHODS: During a 16-month period 2 boys and 42 girls underwent extravesical ureteral reimplantation and received similar postoperative care by a single pediatric urologist (D. P. S.). These children were 1 to 14 years old (mean age 4.7) and underwent reimplantation for correction of primary vesicoureteral reflux due to breakthrough urinary tract infections, moderate/high grade reflux and parental desire. Unilateral and bilateral reimplantations were done in 21 and 23 children, respectively, and 9 underwent reimplantation of duplex systems. Each child received 0.25 to 0.5% marcaine locally instead of caudal at termination of the surgical procedure. Criteria for patient discharge home included sufficient urine output, toleration of a liquid diet, adequate pain control with oral analgesics and "parental readiness." Renal and bladder ultrasound was obtained no earlier than 1 month following surgery. Postoperative cystograms were obtained in any child with a febrile urinary tract infection or at parental request. Charts were reviewed for demographics, operative procedures, postoperative intravenous analgesic doses, catheter requirements and length of stay, defined as hours from surgery to discharge home. Surgical outcomes were analyzed specifically for perioperative complications and resolution of reflux on postoperative cystograms. RESULTS: The length of stay for all children ranged from 5 to 30 hours (average plus or minus standard deviation 13.3 +/- 6.8). Of the children 31 (70.5%) were discharged home the same day while the remaining 13 (29.5%) went home the next day. When comparing the outpatient surgical group to those hospitalized for 1 night, there were no significant differences in age, operative times and technique (unilateral versus bilateral). Children discharged home the same day required significantly fewer doses of intravenous analgesics (1.7 +/- 0.23 versus 2.7 +/- 0.36, p = 0.025). Intravenous narcotics were primarily used in the recovery room and ketorolac tromethamine was administered on the surgical ward. Seven children were discharged home with urethral catheters due to urinary tract infection in 1, transient urinary retention in 4 and surgeon preference in 2. Those patients discharged home with an indwelling catheter had a significantly longer length of stay (hours) compared to those without catheters (20.3 +/- 8.3 versus 12.0 +/- 5.6, p = 0.026). The child discharged home with a catheter due to urinary tract infection was rehospitalized 2 days later and received 48 hours of intravenous antibiotics. Postoperative cystograms revealed resolution of reflux in 12 of 13 children (92.3%). One child with preoperative bilateral high grade reflux had unilateral reflux on postoperative cystogram. Followup of 41 children at 3 to 19 months (mean 9.1) revealed no other significant complications. CONCLUSIONS: In our experience extravesical ureteral reimplantation for the correction of primary reflux can be done on an outpatient basis in the majority of children without an increase in morbidity. Pain management and catheter placement significantly influence length of stay in children undergoing extravesical ureteral reimplantation.

Adolescent↗
PubMed1997

Outcome after reinfection following reimplantation hip arthroplasty.

Between 1976 and 1992, reinfection developed in 34 patients treated for an infected total hip arthroplasty with removal of the prosthesis and implantation of another prosthesis. These patients included 15 men and 19 women with a mean age of 62 years. Infection recurred an average of 2.2 years after reimplantation of the new prosthesis. Followup after the diagnosis of reinfection averaged 5.1 years. Reinfection after an attempt at reimplantation total hip arthroplasty was seldom compatible with a good functional outcome. Resection arthroplasty was reliable in eradicating reinfection but led to poor function and was associated with persistent pain. Although reimplantation of a third prosthesis allowed 3 patients to achieve an excellent result, the 8 hips that failed a third reimplantation attempt had the worst functional results in this study. The results from the present series suggest that reinfection after an attempt at reimplantation is a contraindication to further attempts at a 1-stage reimplantation of another prosthesis. Those patients in whom the same single microorganism has been identified from the failed primary total hip and from the failed first reimplantation, however, may be reasonable candidates for an attempt at a 2-stage reimplantation of a third prosthesis, particularly when a deficiency in prior antibiotic therapy or surgical technique can be identified.

Adult↗
PubMed2001

Cochlear reimplantation: surgical techniques and functional results.

OBJECTIVES/HYPOTHESIS: The most common indication for cochlear reimplantation is device failure. Other, less frequent indications consist of "upgrades" (e.g., single to multichannel), infection, and flap breakdown. Although the percentage of failures has decreased over time, an occasional patient requires reimplantation because of device malfunction. The varying designs of internal receiver/stimulators and electrode arrays mandate an examination of the nature and effects of reimplantation for the individual designs. The purpose of the current study was to investigate the reimplantation of several implant designs and to determine whether differences in surgical technique, anatomical findings, and postoperative performance exist. STUDY DESIGN: Retrospective chart review. METHODS: The subjects were 33 of 618 severely to profoundly deaf adults and children who had implantation at the New York University Medical Center (New York, NY) between February 1984 and December 2000. The subjects had previously had implantation with either a single-channel 3M/House (House Ear Institute, Los Angeles, CA) or 3M/Vienna (Technical University of Vienna, Vienna, Austria) device or with one of the multichannel Clarion (Advanced Bionics, Sylmar, CA), Ineraid (Smith & Nephew Richards, TN), or Nucleus (including the Contour) devices (Cochlear Corp., Englewood, CO) before reimplantation. RESULTS: Length of use before reimplantation ranged from 1 month to 13 years and included traumatic and atraumatic (electronic) failures, as well as device extrusion or infection. Results indicated that postoperative performance was either equal to or better than scores before failure. None of the devices explanted caused damage that precluded the implantation of the same or an upgraded device. These findings support the efficacy and safety of internal implant designs as related to the maintenance of a functional cochlea for the purpose of reimplantation. CONCLUSIONS: Cochlear reimplantation can be performed safely and without decrement to performance. The number of implanted electrodes at reinsertion were either the same or greater in all cases.

Adult↗