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Case Reports
. 2025 Feb;15(2):80-85.
doi: 10.13107/jocr.2025.v15.i02.5236.

Total Hip Arthroplasty in Ochronotic Arthropathy with quadriceps tear. A Case Report with a Review of the Literature

Alok Chandra Agrawal  1 , Anuj Baghel  1 , Ankit Kumar Garg  1 , Alok Rai  1 , Harshal Sakale  1
Affiliations
Case Reports

Total Hip Arthroplasty in Ochronotic Arthropathy with quadriceps tear. A Case Report with a Review of the Literature

Alok Chandra Agrawal et al. J Orthop Case Rep. 2025 Feb.

Abstract

Introduction: Alkaptonuria is a rare genetic disorder characterized by the absence of the enzyme homogentisate 1,2 dioxygenase, which leads to the accumulation of homogentisic acid in connective tissues and blood, resulting in Ochronosis and osteoarthropathy.

Case report: We present a case report of a 56-year-old male with ochronotic arthropathy and quadriceps tendon rupture who underwent a total hip replacement. The patient exhibited right hip pain, difficulty walking, and restricted movement at the hip and spine. Radiographic and magnetic resonance imaging findings confirmed significant arthritic changes in the right hip joint and a mid-substance tear in the quadriceps tendon. Intraoperatively, dark pigmentation was observed in the affected tissues, consistent with the diagnosis of Ochronosis. The literature review indicates that joint replacement surgery is the treatment of choice for ochronotic arthropathy, with patients experiencing good functional recovery. The prosthesis's long-term survival rate is comparable to primary arthroplasty, and the optimal surgical approach regarding capsule preservation remains a topic of debate.

Conclusion: Joint replacement is a feasible treatment option for patients with ochronotic arthropathy. Understanding the spine-pelvic relations and other potential complications can help surgeons plan for better recovery and functional outcomes.

Keywords: Ochronotic arthropathy; alkaptonuria; total hip replacement.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
The clinical image of the patient from front, side, and behind.
Figure 2
Figure 2
Pre-operative radiographs of the pelvis with both hip and lumber spine.
Figure 3
Figure 3
Radiographs of right knee with thigh and magnetic resonance imaging (T2-weighted images) of right thigh with knee.
Figure 4
Figure 4
Intraoperative images; (a) dark-colored cut femoral head (b) black discoloration of acetabular articular surface (c) uncemented acetabular shell placement.
Figure 5
Figure 5
Post-operative radiographs after total hip replacement.
See this image and copyright information in PMC

References

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