OPERATIVE TREATMENT OF TUBERCULOSIS OF THE KNEE JOINT

1. In treating tuberculosis of the knee joint, the best results are obtained by operative intervention.

2. At present we are not concerned with the question of whether or not an operation should be performed, but with more accurate indications for the operation.

3. Adolescence and maturity are the most suitable ages for operation. Excellent results have also been obtained in old age. Evidence has also been accumulating which indicates that economic resection may be successfully performed on patients between the ages of ten and fourteen, if care is taken not to injure the epiphyseal cartilages.

4. The best time to perform an operation for ankylosis is the period of abatement of the process. The initial stages of tuberculosis in the knee joint are not suitable for operation.

5. The success of operative interference does not depend upon the removal of all affected tissues. The operation should be a simple one, aiming chiefly at the formation of ankylosis. The bone foci should be thoroughly curetted and filled with bone chips.

6. No clamps, braces, or wires should be employed, but it is important to fix the knee in a position of slight flexion.

7. Neither the operation of Robertson Lavalle, nor "nailing", nor "osteotomia medicata" is to be recommended in cases of tuberculosis of the knee joint.

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