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Journal of Bone and Joint Surgery, 1953;35:577-588.
© 1953 by The Journal of Bone and Joint Surgery, Inc

THE USE OF IPRONIAZID IN THE TREATMENT OF BONE AND JOINT TUBERCULOSIS

David M. Bosworth M.D.1, Howard A. Wright M.D.2, J. William Fielding M.D.1, and Hudson J. Wilson Jr. M.D.1

1 Orthopaedic Service of St. Luke's Hospital, New York City, and Sea View Hospital, Staten Island, New York
2 Orthopaedic Service of St. Luke's Hospital, New York City, Sea View Hospital, Staten Island, New York

1. Iproniazid has a great effect in the control of bone and joint infection by the Mycobacterium tuberculosis.

2. For the present we believe iproniazid to be the drug of choice in the treatment of tuberculous bone and joint lesions. It has proved of great value in patients not responding satisfactorily to preceding antibiotic therapy.

3. Patients under medication exhibit multiple evidences of toxicity. All these are mild or reversible and appear unimportant, except possibly psychosis. Psychoses appear rarely, can probably be avoided by dosage reduction, and also seem reversible.

4. Iproniazid therapy must be combined with good medical care, dietary care, and surgery when indicated.

5. It may be that, by the use of this drug in children, a tuberculous weight-bearing joint may he spared arthrodesis. Never before have we felt we could make such a statement.

6. In tuberculous patients with severe or multiple involvement, a percentage of mortality and failure must be expected.


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