Study on operative treatment of bone and joint tuberculosis

1) Experience in tratment of tuberculosis of the bone and joint by combined constitutional, anibiotic and operative measures is deseribed. 2) In the vest majority of cases in the convalescent stage, simple curettage of affeected tissue give excellent results. In tuberculosis of the acetabular roof, curettage of lesion through extraarticular route saved joint function. 3) In tuberculosis of the hip joint with severe destruction of the acetabulum or femoral head and the unaffected upper acetabular margin after curettage of lesion resulted in rapid bony union. 4) In tuberculosis of the hip joint with long-standing extraarticular pseudarthrosis with adduction deformity, subtrochanteric osteotomy producing abduction of the lower fragment resulted in sound union. 5) In tuberculosis of the bone and joint without secondary infection or draining sinus, intraarticular bone grafting after curettage of lesion gave excellent results. However, this procedure should be avoided in joint tuberculosis of children, in which simple curettage frequently results in acure with restoration of joint function. These experiences in operative treatment of bone and joint tuberculosis proved that the four basic principles in operative treatmentーcurettage of affected area, close contact between both affected articular ends, loading on the affected ioint and vitalization of the bone abjacent to focusーwere available. One must be warned, therefore, against an unwarranted confidence in the effectiveness of these operative measures.