Some Orthopædic Procedures Employed in the Treatment of Arthritis

Abstract

(1) A series of six cases of ankylosing spondylitis was shown to illustrate the benefit gained, even in very long-standing cases, by the following regime: ( a) Complete rest in a plaster shell. ( b) Gradual correction of kyphosis by adding thin layers of padding under the dorsolumbar junction, and subtracting similar layers of padding from under the head, to increase extension in the spine. ( c) Deep-breathing exercises practised constantly while the patient is lying in a plaster shell. ( d) Daily physiotherapy. ( e) The fitting of a Goldthwaite spinal brace to maintain the position of maximum correction that has been obtained. The improvement was manifested in all cases by alleviation of symptoms, improvement in posture, and increased chest expansion. (2) A series of six cases of arthritis of the knee was shown, including rheumatoid arthritis, infective arthritis and osteo-arthritis, illustrating treatment by rest plasters, followed by: ( a) Arthrotomy and lavage—where swelling and effusion persist, and ( b) Bone drilling—where bone changes are marked and there is constant pain at rest. Improvement was manifested by relief of symptoms, subsidence of signs of inflammation, and restoration of a considerable degree of movement. (3) A case of arthritis of the tarsal and metatarsal joints, illustrating relief of symptoms afforded by the application of a plaster boot.