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November 26, 1887


JAMA. 1887;IX(22):688-690. doi:10.1001/jama.1887.02400210016003

Surgical Tuberculosis.  —(See the preceding numbers of The Journal.) 24. In regard to the treatment of tuberculous affections of joints, I believe that parenchymatous injections with a Pravaz's syringe (of tincture of iodine, carbolic acid, sublimate, arsenic, etc.) have thus far given no results worth mentioning. Puncture of the joint with a large trocar (an abdominal trocar), and subsequent washing out with disinfecting and other solutions, is effective only in exceptional cases (Hydrops tuberculosus, etc.). In regard to operative procedures, the following are to be considered:

  • Incision (and where possible double incision) and drainage, with or without scraping out the joint with the sharp spoon (Arthrotomy).

  • Total extirpation of the capsule of the joint, making a large incision as when opening the joint for resection, leaving the bony epiphyses and articular cartilages (Arthrectomy or arthrectomia synovialis).

  • Resection of the joint, with simultaneous extirpation of the capsule of the joint, but