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Biomedical subjects

H B Kemp

Publications and source records attributed to H B Kemp.

At least 19 recordsLinked to original sources
PubMed1996

Aseptic loosening in cemented custom-made prosthetic replacements for bone tumours of the lower limb.

We have made a retrospective study of 1001 custom-made prostheses used as replacements after surgery for bone tumours. There were 493 distal femoral, 263 proximal femoral and 245 proximal tibial prostheses. Aseptic loosening was shown to be the principal mode of failure of the implants, and 71 patients had revision for aseptic loosening of a cemented intramedullary stem. The probability of a patient surviving aseptic loosening for 120 months was 93.8% for a proximal femoral replacement, 67.4% for a distal femoral prosthesis and 58% for a proximal tibial implant. In patients with distal femoral replacements the age of the patient at the time of operation and the percentage of bone resected were related to the risk of aseptic loosening. Young patients with distal femoral prostheses in whom a high percentage of the femur had been replaced had the poorest prognosis for survival without aseptic loosening. The percentage of bone removed had a significant effect in the proximal tibial replacement group, but the age of the patient did not. By contrast, neither the age nor the percentage of bone removed was a factor after proximal femoral replacement. The significance of these findings is discussed in relation to mechanical factors.

Adolescent↗
PubMed1990

Parosteal osteosarcoma. Treatment by wide resection and prosthetic replacement.

We have reviewed 20 cases of parosteal osteosarcoma treated by wide local resection and prosthetic replacement and followed up for six to 17 years. Limb function was excellent in 85%. One patient with grade III histological disease developed pulmonary metastases. Four patients had local recurrences, which were related to repeated preliminary biopsies, inappropriate siting of biopsy and vascular encroachment by the tumour. After this mode of treatment, the outcome was not related to medullary invasion by the tumour.

Adolescent↗
PubMed1988

Movement of the shoulder after resection of a tumor of the scapula.

Forty-seven patients who had a tumor of the scapula were seen by the Bone Tumour Panel at the Royal National Orthopaedic Hospital, Stanmore, Middlesex, England. Sixteen resections were performed in fourteen patients. Although other authors have discussed the length of survival of one or a few such patients, none, to our knowledge, has reported on postoperative movement of the shoulder. We correlated the type of resection of bone and muscle with the restrictions of postoperative movement. Our patients had an excellent range of postoperative movement, even after subradical resection. The study enabled us to make recommendations for reconstruction of muscle after resection and to determine the functional prognosis.

Adolescent↗
PubMed1987

Distal femoral replacement by custom-made prostheses. Clinical follow-up and survivorship analysis.

We report the long-term clinical follow-up and survivorship analysis of 40 distal femoral replacements performed between 1964 and 1980 for traumatic, locally aggressive and malignant conditions. Custom-made prostheses with fully-constrained knee joints were used to replace a mean of 42% of the length of the femur. Survivorship analysis showed a cumulative success rate of 80% at eight years, with no subsequent deterioration at 18 years. Clinical assessment revealed 78% excellent or good results. Failure was due to infection in three cases, and in two to fracture of a now-outmoded femoral stem.

Artificial Limbs↗
PubMed1987

The Chiari pelvic osteotomy. A review of the long-term results.

We report the clinical and radiographic results of the Chiari pelvic osteotomy in 49 hips (45 patients) at an average of 14 years after operation. Of these hips, over half had minimal or no pain, had good or excellent results as assessed by the Harris hip score, and could walk at least three miles; three-quarters, however, had a positive Trendelenburg sign. A younger age at operation and a painless hip with no radiographic evidence of degeneration before operation were associated with a higher hip score at review. The percentage of hips without degenerative changes fell from 68% before operation to 15% at final review. There were no major complications and it was found that a Chiari osteotomy need not interfere with normal childbirth.

Acetabulum↗
PubMed1986

Perthes' disease in rabbits and puppies.

An effusion was simulated in the hip joints of rabbits and puppies known to be susceptible to Perthes' disease. The effusion was produced by the injection of glycol wax. The object of producing the effusion was to show that a transitory interruption of the venous flow was capable of producing changes that would subsequently manifest the pathologic changes and establish a Perthes-like disease.

Animals↗
PubMed1982

Petriellidium boydii infection of the knee: a case report.

A case of Petriellidium boydii (synonym: Allescheria boydii) infection of the knee joint is described. It followed a penetrating soft tissue injury with a pitchfork. Such infections are rare in this country and bone involvement has not been recorded previously except in maduramycosis contracted in tropical areas.

Arthritis, Infectious↗
PubMed1982

A review of the morphology of Perthes' disease.

There are differences of opinion about the pathogenesis of Perthes' disease. All are agreed that it is due to ischaemia, but the cause of this and the size and number of infarctions are in dispute. Through the generosity of the contributors six whole femoral heads and core biopsies of five other cases have been studied radiographically and histologically. The findings ranged from an ischaemic arrest of ossification in the capital articular cartilage without infarction to multiple complete infarctions of the epiphysial bone. The ensuing reparative process contributes to the pathology, which is of a range to warrant grading or grouping.

Cartilage, Articular↗
PubMed1981

Endoprosthetic replacement of the proximal femur and acetabulum. A survival analysis.

A series of 81 patients has been reviewed to determine the value of endoprosthetic replacement of the proximal femur and hip in the treatment of bone tumours. Standard statistical methods were used to evaluate the survival of the replacements and the patients. Taking removal of the prosthesis, irrespective of the cause, as the criterion for failure the survival of the replacements was found to be 63 per cent after 10 years. If deaths are regarded as failures, then the survival value falls to 48 per cent. The survival of patients with chondrosarcoma and osteoclastoma treated by endoprosthetic replacement compares favourably with survival after amputation or excision of the tumour.

Adolescent↗
PubMed1975

Incidence of metal sensitivity in patients with total joint replacements.

Sensitivity to chromium, cobalt, nickel, molybdenum, vanadium, and titanium was studied by patch tests in 50 patients who had received total joint replacements. Nineteen (38%) were sensitive to one or more of the metals. In 23 patients non-traumatic failure of the prosthesis had occurred, and 15 of these patients were sensitive to metal. Out of 27 patients with no evidence of prosthesis loosening, four were sensitive to nickel and cobalt or nickel only. Dermatological reactions occurred in 13 patients after surgery; in only eight, however, was there evidence of metal sensitivity. These findings indicate that metal-on-metal total joint replacements may sensitise the patient to metals contained in the prosthesis. Although there is a high incidence of prosthesis failure among metal-sensitive patients it remains uncertain whether the loosening causes the sensitisation or vice versa.

Chromium↗