Total knee arthroplasty in ochronosis

Patel, Vaibhav

doi:10.1016/j.artd.2015.03.003

Cited by 19 publications

(19 citation statements)

References 7 publications

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“…In accordance with the literature, our case report demonstrates that total hip and total knee arthroplasty has an excellent outcome in patients with severe degenerative arthropathy, secondary to ochronosis, with survival comparable to prosthesis in patients with osteoarthritis (17,20,21).…”

Section: Discussionsupporting

confidence: 90%

“…In case of severe arthropathies, if conservative treatment are not effective, the only alternative is the joint replacement under general or spinal anesthesia (11)(12)(13)(14); care must be taken with regard to the weakness of the bone, and the altered strength and resistance of tendons and ligaments with high risk of intraoperative complications affecting the stability and survival of joint prosthesis. There are a few, rare case reports describing joint arthroplasty in the literature (14)(15)(16)(17)(18)(19). No complications or other adverse events have been reported (12)(13)(14)(15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

“…There are a few, rare case reports describing joint arthroplasty in the literature (14)(15)(16)(17)(18)(19). No complications or other adverse events have been reported (12)(13)(14)(15)(16)(17). Most of the recently published studies report excellent outcomes for joint replacement surgery (13).…”

Section: Discussionmentioning

confidence: 99%

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Arthroplasty in Alkaptonuric Ochronosis

Zmerly¹,

Moscato²,

Gregori³

2019

jptcp

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Ochronotic degenerative arthropathy occurs in patients with alkaptonuria. Alkaptonuria disorder is an extremely rare disease characterized by black pigmentation of various tissues (e.g., cartilage and connective tissue). Ochronotic arthropathy is a disabling disease that primarily affects the large joints. Like other metabolic diseases that involve the musculoskeletal system, care must be taken with regard to the quality of the affected bones, tendons and ligaments, and therefore the stability and survival of joint prosthesis. The following is a report of a 66-year-old man affected by several musculoskeletal manifestations of alkaptonuria with severe joints disruption, who was successfully treated with total left hip and total right knee replacements. Surgical, anesthesiological and postoperative management of these patients may require more vigilance due to the associated comorbidities of this disorder.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Arthroplasty in Alkaptonuric Ochronosis

Zmerly¹,

Moscato²,

Gregori³

2019

jptcp

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“…The number of case reports was limited, with the most recent available report being in 2016, which was 1 year from the commencement of our systematic review. Apart from ours and reports from Patel [5], Ozmanevra et al [8], and Aydoğdu et al [22], there are no formal outcome scoring which makes the comparison across studies difficult. Furthermore, not all information regarding the implants used was available, which limits our interpretation.…”

Section: Discussionmentioning

confidence: 94%

Total Knee Arthroplasty in Ochronosis Arthropathy: A Case Report and Systematic Review

Lee

Tan

Chan

2019

Case Reports in Orthopedics

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Introduction Ochronosis arthropathy (OcA) is a rare condition which may be treated with total knee arthroplasty (TKA) at the end stage. The condition is often discovered only intraoperatively and the ideal choice of TKA is unknown. Case Presentation A 54-year-old male with worsening chronic bilateral mechanical knee pain had failed conservative therapy. Posterior stabilised (PS), cemented TKA and patella resurfacing was performed. Intraoperatively, collagenous structures such as the menisci and cartilage were noted to be black. Histological examination showed deposition of large amorphous brown material suggestive of ochronosis. He recovered well and underwent TKA of the contralateral knee the following year. At 2 years postindex TKA, his outcome scores improved and he was satisfied. Discussion and Conclusion With increasing TKA performed worldwide, a surgeon may eventually be surprised by the above findings once in their lifetime. However, OcA may be considered a likely diagnosis and it is safe to proceed with TKA. There is no particular TKA design that proved to be superior in our systematic review of 19 publications regarding TKA as all reported good outcomes. However, as the pathogenesis of OcA appears to be inflammatory in nature, we suggest using cemented PS TKA with resurfacing of the patella.

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“…Systemic metabolic diseases cause diminution in bone density, and only limited cases of ochronotic arthropathy can be found in the medical literature because of the rarity of the disease [6][7][8][9]. This report presents the case of a man with bilateral hip and knee ochronotic arthropathy who underwent arthroplasty for all affected joints with a long-term follow-up of 12 years.…”

Section: Introductionmentioning

confidence: 99%

Long-term follow-up of bilateral hip and knee arthroplasty secondary to ochronotic arthropathy

et al. 2020

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Alkaptonuria is a rare metabolic disorder caused by the deficiency of homogentisic acid oxidase enzyme, which is responsible for eliminating homogentisic acid from the body through the renal system. Excessive accumulation of homogentisic acid leads to ochronosis and ochronotic arthritis. Owing to the rarity of the disease, long-term functional outcomes of joint replacements of the hips and knees in ochronosis arthropathy are unconfirmed, and only a limited number of case reports are available on this. We present a case of a 45-year-old man with ochronosis and advanced osteoarthritis of both the hips and knees. He underwent bilateral hip and knee replacements as staged procedures. At a follow-up of more than 12 years, the man had full mobility with no loosening of implants.

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Total knee arthroplasty in ochronosis

Cited by 19 publications

References 7 publications

Arthroplasty in Alkaptonuric Ochronosis

Arthroplasty in Alkaptonuric Ochronosis

Total Knee Arthroplasty in Ochronosis Arthropathy: A Case Report and Systematic Review

Long-term follow-up of bilateral hip and knee arthroplasty secondary to ochronotic arthropathy

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