A treatise on orthopedic surgery . atella or in thehead of the fibula, or primarily in the synovial membrane. In 547 cases,^ about two-thirds of which were in adults,treated at Koenigs clinic at Gottingen by operative procedureswhich permitted inspection of the joint, 281 ( per cent.)were apparently examples of primary osteal disease; 266 ( ^ Die Specielle Tuberculose der Knochen und Gelenke, Berlin, 417 418 OETHOPEDIC SUBGEB¥. per cent.) were primarily synovial. The focus was in the femurin 93 instances ( per cent.), in the tibia in 107 ( percent.), in the patella in 3
A treatise on orthopedic surgery . atella or in thehead of the fibula, or primarily in the synovial membrane. In 547 cases,^ about two-thirds of which were in adults,treated at Koenigs clinic at Gottingen by operative procedureswhich permitted inspection of the joint, 281 ( per cent.)were apparently examples of primary osteal disease; 266 ( ^ Die Specielle Tuberculose der Knochen und Gelenke, Berlin, 417 418 OETHOPEDIC SUBGEB¥. per cent.) were primarily synovial. The focus was in the femurin 93 instances ( per cent.), in the tibia in 107 ( percent.), in the patella in 33 ( per cent.), and in more thanbone in 48 ( per cent.). The examination of a joint permitted by arthrectomy or ex-cision cannot be sufficiently thorough to exclude disease of thebone and to establish the diagnosis of primary disease of thesynovial membrane, but in 92 instances the opportunity wasoffered by amputation at the thigh, 80 of the patients beingadults. This examination, presumably thorough, showed the Fig. Acute tuberculous arthritis of the knee. primary disease to be of the bone in 50 cases, while in 35 thesynovial membrane was apparently the seat of the primary affec-tion. In 17 of the 50 cases in which the disease was osteal, thefocus was in the femur; in 7 it was in the internal condyle, in TUBEBCULOUS DISEASE OF THE KNEE-JOINT. 419 Fig. 290. 6 in the external condyle, and it was in other situations in 4cases. In 17 the primary disease was of the tibia; in 5 of theinternal tuberosity; in 5 of the external tuberosity; in othersituations 7. In 5 instances the primary disease was of thepatella, and more than one bone was involved in 11 ^ states that he has examined 120 tuberculous joints ofadults and children, after excisionor amputation, or at autopsy, andin every instance primary foci inthe bone were discovered. He be-lieves primary disease of the syno-vial membrane to be very uncom-mon, and asserts that examina-tions are of no particu
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Keywords: ., bookauthorwhitmanr, bookcentury1900, bookdecade1910, bookyear1910
