Excision of the knee joint with report of twenty-eight cases . inflammatory action. In the meantime the leg was bandagedand supported on a splint to secure rest. Excision of the joint was performed on Thursday, the 14thDecember, 1882. A semilunar incision was carried across belowthe patella, freely opening the joint. The articulating surface ofthe patella was found denuded of cartilage and roughened. Thesynovial membrane was changed in structure, and presented pulpythickening. The ligaments of the joint were greatly relaxed. Notrace of the semilunar cartilages existed; the anterior crucialliga
Excision of the knee joint with report of twenty-eight cases . inflammatory action. In the meantime the leg was bandagedand supported on a splint to secure rest. Excision of the joint was performed on Thursday, the 14thDecember, 1882. A semilunar incision was carried across belowthe patella, freely opening the joint. The articulating surface ofthe patella was found denuded of cartilage and roughened. Thesynovial membrane was changed in structure, and presented pulpythickening. The ligaments of the joint were greatly relaxed. Notrace of the semilunar cartilages existed; the anterior crucialligament was detached in front, but the posterior still articular facets of the head of the tibia were eroded, that onthe outer side being more advanced. The cartilage over bothcondyles was also broken down and removed in patches, leavingthe bone exposed. The patella was removed with its investingsheath, and the soft parts being reflected, the saw was applied. Athin slice was taken from the end of the femur, cuttins:; from Case 27. ^ >. ilp^u^i^:. EXCISION OF THE KNEE JOINT. Operation performed 14th December, taken 7th February, 1883. EXCISION OF THE KNEE JOINT. 61 before backwards, leaving a convex surface. The head of thetibia was then removed, the saw carried from behind forwardsand leaving it concave. All bleeding points were ligatured. Thethickness of bone removed was one and one-sixteenth leg was then put up after Dr. P. H .Watsons method, withplaster of Paris and a coating of paraffin ; the wound closed bythree wire sutures with intermediate sutures of catgut. A good-sized drainage tube was introduced at each angle, and anantisepticdressing applied. The operation was carried on under the spray •At night a hypodermic injection of a sixth of a grain of morphiawas administered, as she was restless and nervous ; this producedthe desired effect. She did not sleep but passed a quiet night. As there was no discharge from the wound, I left
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