Bony ankylosis has long been the desired end-result in tuberculosis of a joint. It is generally believed that the pathological process has the best opportunity of becoming and remaining arrested when ankylosis occurs. Joint motion, on the other hand, is precarious with regard to progression and relapse. Therefore, one must assume that any drug therapy must eventuate in complete eradication of the infection unless osseous ankylosis is still to be considered as the desired end-result.
Drug therapy and its limitations in chronic infection of bone alone are becoming more clearly recognized. The presence of decreased local vascularity, massive fibrosis, necrosis, sequestrums, and other encapsulated foci would lead one to expect poor results in drug therapy. These conditions result in failure to obtain satisfactory local levels at the source of the infection. When critically analyzed, little evidence exists to warrant any conclusions that such therapy is beneficial in cases of long-standing
Smith WS, Bailey RW. EFFECT OF STREPTOMYCIN IN SYNOVIAL TUBERCULOSIS OF THE KNEE. JAMA. 1953;152(9):792–794. doi:10.1001/jama.1953.03690090016004
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