Contributions to the surgery of diseased joints : with especial reference to the operation of excision. No. 1. The knee / by P.C. Price.

  • Price, P. C. (Peter Charles), 1832-1864.
Date:
1859
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to the surgery of diseased joints : with especial reference to the operation of excision. No. 1. The knee / by P.C. Price. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    into cellular and other structures, favours the formation of abscesses, which, when opened or bursting of themselves, admit the exit of a discharge composed of the softened strumous material, more or less mixed with blood, pus, and the debris of carious or necrosed bone. It would appear from the above description, that this form of disease may exist for some time, or even nm its course, without in- cluding the neighbouring articulation; but, imfortunately, it is seldom that the joint escapes the destructive process. At an early period the articulation begins to sympathise, and ere long becomes seriously affected. When the first stage of the disease is well established, and the foreign material which has been deposited in the cancellous texture begins to soften, the boundaries of the joint are invaded. By changes degenerative and destructive the cartilages dis- appear, and permit the extrusion of the morbid contents of the diseased bone into the joint cavity. The synovial mem- brane, if not already involved, thickens, and greatly alters in structure ; its functions are destroyed, and, instead of ful- filling its proper duties, becomes the cause of more serious implication. The ligaments, put upon the stretch by the increasing size of the joint, soften, and permit deformity and luxation to take place. The presence of irritating matter in the closed cavity soon leads to suppuration, and perforation of its walls. Thickening and abscesses include cellular and other tissues, and ere long circuitous channels are formed, with external openings, which admit the escape of the cause of so much disturbance. The accompanying woodcuts of the knee-joint of a little girl, destroyed by this form of disease, which I was com- pelled to remove by amputation of the thigh, well illustrate many of the features to which I have briefly alluded.* The disease, in this instance, commenced in the head of the tibia, and succeeded in converting that bone into a vast cavern, * These and accompanying illustrations are from the graphic pencil of Dr. Westmacott, Delineator of Anatomy and Pathology in Khig’s College, London.