The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . ject of this case, Kate H., twenty-sixyears of age, was sent to me by Dr. W. H. Bunn, of Philadelphia, and was admitted tothe Eipiscopal Hospital on March 20, 1876. She had suflered more or less from diseaseof the left knee since she had been seven years old, the last attack having kept her inbed six months, and the joint at the time of her admission being very painful ami ten-der, swollen, and somewhat contracted; the tibia was displaced backwards, and distinctgrating was elicited on movi
The international encyclopaedia of surgery; a systematic treatise on the theory and practice of surgery . ject of this case, Kate H., twenty-sixyears of age, was sent to me by Dr. W. H. Bunn, of Philadelphia, and was admitted tothe Eipiscopal Hospital on March 20, 1876. She had suflered more or less from diseaseof the left knee since she had been seven years old, the last attack having kept her inbed six months, and the joint at the time of her admission being very painful ami ten-der, swollen, and somewhat contracted; the tibia was displaced backwards, and distinctgrating was elicited on moving the articulation, while the characteristic jumping orstarting pains at night showed the erosion of the articular cartilages, and tiie im-plication of the underlying bone. The patients general condition was, however, satis-factory, and there was no evidence of the j)resence of any visceral disease. After consultation with my colleagues, I excised the joint in the usual way on March24, securing the limb after the operation in the bracketed wire splint, and placing the EXCISION OF THE KNEE-JOINT. 617. Result of excision of the knee-joint. whole on a pillow and in a large fracture-box. The condi- Fig. 744. tion of the joint, when it was laid o|)en, amply justified our decision as to the necessity of interference, the semilunar cartilages liaving entirely, and the crucial ligaments almost, disappeared, the articular cartilages being eroded, and the femoral condyles and tibia being carious. The greater part of the joint was obliterated by tlie existence of intra-articular adhesions, while in front of the femur there was a portion of synovial membrane which had undergone the gelatiniform change, thus illustrating the fact, which is familiar to surgeons wlio see many of these cases, that the gelatinous and the ordinary Ibrm of artliritis often coexist in the same case, and that, as regards their pathology, they differ in degree rather than in kind. The convalescence of tliis patient
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