Excision for Tuhercular Knee-joint. 461 



7. 89. Anchylosis after Tubercular Arthritis.— Bones of a 



left knee-joint — macerated, showing bony anchylosis in the 

 straight position. 



There is a considerable gap between the condyles of the 

 femur, chiefly at the expense of the outer, but the walls of the 

 gap seem to have healed. The osseous anchylosis between the 

 condyles of the femur and tuberosities of the tibia is formed 

 by well-developed cancellous tissue. The texture of the bones 

 is firm and free from grease. W. C. H. 47. 



d. Results of operations for tubercular disease of the knee. 



7. 90. Return of Tubercular Disease after Excision of the 

 Knee. — Section of an injected knee of a lad aged 16 years — in 

 spirit, illustrating the above. 



The limb was amputated two months after excision on account of 

 the continuation of discharge from several sinuses. 



The specimen shows, however, that the soft parts rather 

 than the bone have been involved by the return of tuberculosis. 

 The ends of the bones are fatty, but not tubercular. Two 

 caseous centres may be seen behind the lower end of the femur. 

 A line of fibrous tissue indicates the junction of the two bones. 



G. C. 3071. 

 Fresenied by A. G. Millei;, F.R.C.S.E. 



7. 91. Return of Tubercular Disease after Excision of the 



Knee. — Section of the knee-joint of a child after excision — in 

 spirit, showing the position of a tubercular sinus. 



The child was aged 10 years, and the joint had been excised two 

 years previously in another town for tubercular disease. The limb was 

 amputated by Dr P. H. MacLaren, partly for the persistence of the 

 discharge from a sinus, partly for the fibrous union, and parti)' for the 

 deficient growth of the limb. 



There is a wide fibrous union between the bones. The 

 epiphysis has been removed at the excision from both femur 

 and tibia, thus accounting for the want of growth. A blue rod 



