A range of treatments were employed for tuberculosis of the knee depending on the how badly the joint had been involved. These varied from standard immobilisation techniques using plaster cast or splints to surgical procedures to aid in maintaining movement. Many of the techniques utilised in the treatment of TB were also transferrable to other joint related disease and trauma.

The Thomas Splint

The Thomas Splint was introduced in 1865 for treatment of diseases including tuberculosis. It consisted of a padded oval ring that fitted over the top of the leg and fixed to the pelvis and smaller ring that was positioned on the lower end of the leg attached by two iron bars. A large piece of leather stretched across the iron bars acted as a sling to support the leg, which was strapped in. Traction was applied to the leg by attaching the strappings to the lower ring. This resulted in complete immobilisation of the affected limb. A later addition of a patten, raised shoe, to the lower end of the splint and the shoe of the unaffected leg allowed the patient to walk in the splint. The Thomas Splint was also used for tuberculosis of the hip and in the healing of fractures, see the Non-TB section for further details.

Tenotomy

For more advanced cases of TB of the knee, it was not unusual for a patient to lose flexion in the affected joint and may be left holding it at an unusual angle owing to muscle contracture and possible subluxation, whereby one muscle pulls more strongly than its counterpart causing partial or complete dislocation of the joint. To counter this, a surgical procedure, known as tenotomy, was used which saw the division of the tendon lengthways in half and its reattachment as a means of lengthening it to increase flexion and minimise deformity. Post-operative treatment from this procedure similarly saw the use of splints or plaster cast during healing from the procedure.

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