THE ORTHOPAEDIC ASPECTS OF CHRONIC ARTHRITIS

The Hugh Owen Thomas Lecture, delivered before the Medical Institution of Liverpool, June 2, 1925

¹ John B. and Buckminster Brown Professor of Orthopaedic Surgery, Harvard University

1. Rheumatoid Arthritis is a disease in which no specific organism has been found which can be held constantly responsible for its causation. Probably many different types of organisms and many other factors play etiologic parts in its onset and course.

2. In the early stages of Rheumatoid Arthritis, if these organisms and if the other factors can be overcome, complete recovery is possible. In the later stages, if the factors inimical to normal vitality can be eliminated and the essentials for normal body mechanics can be satisfied, arrest of the disease and great functional betterment may be expected. In this stage the simple eradication of a possible surgical focus of infection will rarely be successful in controlling the progress of the disease.

3. Osteo-Arthritis is a disease in which no specific organism has been conclusively proved to be responsible for its causation. On the basis of the present evidence its manifestations may occur unassociated with any demonstrable remote or local focus of infection.

4. In the early stages of Osteo-Arthritis, if a faulty body chemistry and a faulty body mechanics can be corrected and intra-articular friction can be lessened, almost complete relief of the subjective symptoms is possible. In the latter stages, if intelligent physiotherapy, protective appliances, and well conceived orthopaedic surgery be added to these measures, relief of discomfort and greatly improved function may be expected.

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