Skeletal tuberculosis in New Zealand since the introduction of chemotherapy

The incidence of skeletal tuberculosis in New Zealand as measured by both hospital morbidity and notification data has fallen since the introduction of chemotherapy to low levels comparable with other developed societies. The decline has been greatest in the 5-14 year age group and least in the over 65 group. Individual surgeons can now expect to see few cases in a practising lifetime. Effective chemotherapy is the key to successful treatment. Adequate biopsy is essential, but apart from the drainage of large abscesses the place of surgery in the early management of osteoarticular tuberculosis is discretionary. Early activity can usually be encouraged once chemotherapy is instituted, late reconstruction by joint arthroplasty being available if adequate function is not achieved.