Patients with black hip and black knee due to ochronotic arthropathy: case report and review of literature

Abstract

Ochronotic arthropathy is a manifestation of longstanding alkaptonuria. With increasing age, an accumulation of pigment deposits of homogentisic acid in the joint cartilage results in ochronotic osteoarthritis. We present a case of a 62-year-old female who underwent staged left uncemented total hip and right cemented total knee arthroplasty for osteoarthritis secondary to ochronosis.

Keywords: Ochronosis; Osteoarthritis; Total hip arthroplasty; Total knee arthroplasty.

Figure 1

Preoperative appearance and plain radiographs: A) Ochronotic pigmentation of the sclera; B) Black-blue pigmentation of the external ear; C) Anteroposterior and lateral radiograph of the lumbar spine; D) Anteroposterior radiograph of the hips; E) Anteroposterior radiograph of the knees; F) Antero-posterior radiograph of the right shoulder.

Figure 2

Ochronotic joint manifestations: A) Head of the femur; B) Intraoperatively, the joint surfaces.

Figure 3

Postoperative plain radiographs: A) Antero-posterior radiograph of the right hip showing cementless total hip prosthesis; B) Antero-posterior radiograph of cemented total knee prosthesis; C) Lateral radiograph of cemented total knee prosthesis.