The black bone disease: a case report of ochronotic hip arthropathy

Authors

  • Rahul Rathi Department of Orthopaedic, PIMS, Udaipur, Rajasthan, India
  • Shivam Garg Department of Orthopaedic, PIMS, Udaipur, Rajasthan, India
  • Vishwas . Department of Orthopaedic, PIMS, Udaipur, Rajasthan, India
  • B. L. Kumar Department of Orthopaedic, PIMS, Udaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20223462

Keywords:

Arthroplasty, Alkaptonuria, Ochronosis

Abstract

Ochronotic arthropathy is a rare complication in patients with alkaptonuria (AKU) that arises as a result of accumulation of ochronotic pigment in the joints. This case report presented a 70-year-old female patient with chronic pain in B/L knee and right hip with decreased e range of motion. The physical and radiographic findings were agreeable with end-stage hip osteoarthritis and knee osteoarthritis. The diagnosis was done by finding of a dark capsule and femoral head during the total hip replacement. The surgical treatments significantly minimized and enhanced the range of motion (ROM). AKU normally emerges after age 40 and is normally asymptomatic till the involvement of the spine, hip, knee and shoulder joints. Therefore, orthopedic surgeons must be observant of clinical manifestations of this rare condition, before and during the surgery. Arthroplasty is an appropriate therapeutic recourse for patients suffering from ochronotic arthropathy.

References

Jiang L, Cao L, Fang J, Yu X, Dai X, Miao X. Ochronotic arthritis and ochronotic Achilles tendon rupture in alkaptonuria: a 6 years follow-up case report in China. Medicine (Baltimore). 2019;98(34):16837.

Helliwell TR, Gallagher JA, Ranganath L. Alkaptonuria-a review of surgical and autopsy pathology. Histopathology. 2008;53(5):503-12.

Taylor AM, Boyde A, Wilson PJ, Jarvis JC, Davidson JS, Hunt JA, et al. The role of calcified cartilage and subchondral bone in the initiation and progression of ochronotic arthropathy in alkaptonuria. Arthritis Rheum. 2011;63(12):3887-96.

Gil JA, Wawrzynski J, Waryasz GR. Orthopedic manifestations of ochronosis: Pathophysiology, presentation, diagnosis, and management. Am J Med. 2016;129(5):536.

Harun M, Hayrettin Y, Serhat M, Cuneyt M, Firat F, Ufuk O. A rare cause of arthropathy: An ochronotic patient with black joints. Int J Surg Case Rep. 2014;5(8):554-7.

Patel VG. Total knee arthroplasty in ochronosis. Arthroplast Today. 2015;1(3):77-80.

Rathore FA, Ayaz SB, Mansoor SN. Ochronotic arthropathy: Two case reports from a developing country. Clin Med Insights Arthritis Musculoskelet Disord. 2016;9:15-20.

Siavashi B, Zehtab MJ, Pendar E. Ochronosis of hip joint; a case report. Cases J. 2009;2:9337.

Dom K, Pittevils T. Ochronotic arthropathy: the black hip. Case report and review of the literature. Acta Orthop Belg. 1997;63(2):122-5.

Cebesoy O, Isik M, Subasi M, Kaya A, Bilgin F, Kaya O. Total hip replacement for an ochronotic patient: a technical trick. Am J Case Rep. 2014;15:27-30.

Aliberti G, Pulignano I, Pisani D, Rocchietti MM, Del PF, Proietta M. Bisphosphonate treatment in ochronotic osteoporotic patients. Clin Rheumatol. 2007;26(5):729-35.

Couto A, SaRodrigues A, Oliveira P, Seara M. Ochronotic arthropathy-a rare clinical case. Oxf Med Case Reports. 2018;2018(9):69.

Pachore JA, Shah VI, Upadhyay S, Shah K, Sheth A, Kshatriya A. Primary hip arthroplasty for the treatment of alkaptonuric hip arthritis: 3-to 24-year follow-ups. Arthroplasty. 2019;1(1):1-9.

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Published

2022-12-28