Page 6 - Orthofeed_Issue4_Feb2022

Total Knee Arthroplasty in Ochronosis Arthropathy 05

Preoperative and postoperative (2 years) findings were 1

Parameter Preoperative Postoperative

Range of motion 5° to 100° 0° to 90°

Oxford knee score (OKS) 9 40

Knee Society (KS) function score 0 70

Rare incidental finding Operative pearls for surgery

The finding of black connective tissue by an Cemented TKA should be considered for
orthopaedic surgeon can also be the first ochronosis arthropathy, as it offers

point of suspicion for alkaptonuria in some advantages such as easier technique
patient. 1 ensuring greater primary stability and delivery

of local antibiotics. 1
For a 58-year old female patient, the diagnosis

of ochronosis was made after knee Patellar resurfacing: Tendon can be friable
replacement surgery. 3 and stiff due to ochronotic involvement and

The patient had knee pain since 8 years one should be careful while retracting patella. 3
with no cutaneous signs of ochronosis at

time of presentation. 3 Consider preoperative cardiac clearance
Blackened articular cartilage of femur, tibia, because of possibility of calcified cardiac

and patella; blackened undersurface of valve disease. 3
patella and quadriceps tendons and; dark

black stiff menisci inside the joint made the Future considerations
surgeon highly suspicious of this Future considerations include possible

diagnosis. 3 genetic interventions or the use of nitisinone

for treatment of this disorder. 3
Ochronosis arthropathy should be considered
as a diagnosis when faced with black Blood management, use of bone cement, and

connective tissue intraoperatively. 1 spontaneous quadriceps rupture are all

possible considerations that might enhance
Surgeons may proceed with TKA as it surgical outcomes. 3
provides a good long-term outcome for

end-stage arthropathy. 1