Page 5 - Orthofeed_Issue4_Feb2022

ORTHOFEED, Edition 4 04

Case Report

Total Knee Arthroplasty in Ochronosis Arthropathy

Endorsed by: Dr. Shakir S. Kapadia, Orthopedic Surgeon, Mumbai

Introduction

Ochronosis arthropathy is one of the manifestations in patients with alkaptonuria. 1

It is a rare autosomal recessive disorder which has an estimated prevalence ranging from
1:200,000 to 1:1,000,000 live births worldwide. 2

Alkaptonuria is a disorder of tyrosine metabolism due to deficiency of homogentisic oxidase

characterized by excretion of homogentisic acid in urine, deposition of oxidized homogensitate
pigments in connective tissues and articular cartilages (ochronosis). 3

Need for total knee arthroplasty

The accumulation of homogentisic acid using iASSIST navigation. The patella was
1
results in dark pigmentation and weakening of also resurfaced. (Figure 1)
the tissues leading to chronic inflammation
and osteoarthritis. 3

Initially there is involvement of the

intervertebral joints, with sclerosis of the discs
and osteoporosis of the vertebral bodies. 2

The knee joint is most commonly affected

and total joint replacement in published cases
of ochronotic osteoarthritis report good

results (similar to osteoarthritic patients
without ochronosis). 1, 3 Figure 1: Intraoperative images of the right

knee. Black discoloration is noted on the patella
Case report and trochlea (a). The cancellous bone appears

A 54-year-old male with bilateral mechanical normal after preparation (b)

knee pain who could not climb stairs or walk
for more than 5 min underwent cemented
posterior stabilised total knee arthroplasty

(TKA). The surgery was performed bilaterally