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Okronotik bir hastada total diz artroplastisi sırasında oluşan patellar bağ rüptürü

Year 2014, , 367 - 370, 30.05.2014
https://doi.org/10.3944/AOTT.2014.3245

Abstract

Okronotik artropati çoğunlukla omurga ve büyük eklemleri tutan bir rahatsızlıktır. Eklemin kararmasıyla birlikte, hızlı bir şekilde ve başlıca dizde meydana gelen dejenerasyon 4. veya 5. dekatta belirti vermeye başlar. Tıbbi tedavinin ve eklem koruma cerrahilerinin erken dönemdeki rolü kısıtlı olduğundan, hastaların üçte birinde tek etkili yöntem eklem replasmanıdır. Çalışmamızda okronotik bir eklemin total diz artroplastisi (TDA) sırasında ender görülen komplikasyonlardan patellar bağ rüptürü oluşan bir olgu bildiriyoruz. Elli bir yaşındaki erkek hasta, her iki dizinde varus deformitesi ve hareket kısıtlılığına yol açan şiddetli üç kompartımanlı osteoartrit şikayetiyle bize başvurmuştu. Hastaya çift taraflı TDR yapıldı. Yirmi sekiz ay sonraki kontrolünde, hastanın ağrısız bir şekilde yürüyebildiği ve radyografilerinde implantların uygun konumda olduğu görüldü. Bildiğimiz kadarıyla çalışmamız, okronotik eklemin TDA’sı sırasında patellar bağ rüptürünün görüldüğü ilk çalışmadır. Komplikasyonları engellemek için okronotik eklemin TDA’sı sırasında tendona azami dikkatle yaklaşılmasını ve ameliyat öncesi gerekli hazırlıkların yapılmasını öneriyoruz.

References

  • Groseanu L, Marinescu R, Laptoiun D, Botezatu I, Staniceanu F, Zurac S, et al. A late and difficult diagnosis of ochronosis. J Med Life 2010;3:437-43.
  • Wagner LR, Knott JL, Machaffie RA, Walsh JR. Clinical and pathological findings in ochronosis. J Clin Pathol 1960;13:22-6.
  • Aydoğdu S, Cullu E, Ozsoy MH, Sur H. Cementless total knee arthroplasty in ochronotic arthropathy: a case report with a 4-year follow-up. J Arthroplasty 2000;15:539-43.
  • Konttinen YT, Hoikka V, Landtman M, Saari H, Santavirta S, Metsärinne K, et al. Ochronosis: a report of a case and a review of literature. Clin Exp Rheumatol 1989;7:435-44.
  • Kural C, Cetinus EM, Kural A, Uğraş AA, Kaya I. Knee ochronotic arthropathy and arthroscopic findings. Acta Orthop Traumatol Turc 2009;43:67-71.
  • Raaijmaakers M, Steenbrugge F, Dierickx C. Ochronosis, arthroscopy of a black knee: a case report and review of the literature. Knee Surg Sports Traumatol Arthrosc 2008;16:182-4.
  • West JL, Keene JS, Kaplan LD. Early motion after quadriceps and patellar tendon repairs: outcomes with singlesuture augmentation. Am J Sports Med 2008;36:316-23. Khaled A, Kerkeni N, Hawilo A, Fazaa B, Kamoun MR. Endogenous ochronosis: case report and a systematic review of the literature. Int J Dermatol 2011;50:262-7.
  • Kefeli M, Tomak Y, Can B, Bariş S. Arthroplasty for the treatment of joint degeneration caused by ochronosis in two cases. Acta Orthop Traumatol Turc 2008;42:139-44. Spencer JM, Gibbons CL, Sharp RJ, Carr AJ, Athanasou NA. Arthroplasty for ochronotic arthritis: no failure of 11 replacements in 3 patients followed 6-12 years. Acta Orthop Scand 2004;75:355-8.
  • Braconi D, Bernardini G, Bianchini C, Laschi M, Millucci L, Amato L, et al. Biochemical and proteomic characterization of alkaptonuric chondrocytes. J Cell Physiol 2012;227:3333-43.
  • Manoj Kumar RV, Rajasekaran S. Spontaneous tendon ruptures in alkaptonuria. J Bone Joint Surg Br 2003;85:883-6.
  • Ando W, Sakai T, Kudawara I, Ieguchi M, Miyamoto T, Ohzono K. Bilateral achilles tendon ruptures in a patient with ochronosis: a case report. Clin Orthop Relat Res 2004;424:180-2.
  • Jebaraj I, Rao A. Achilles tendon enthesopathy in ochronosis. J Postgrad Med 2006;52:47-8.
  • Jaureguito JW, Dubois CM, Smith SR, Gottlieb LJ, Finn HA. Medial gastrocnemius transposition flap for the treatment of disruption of the extensor mechanism after total knee arthroplasty. J Bone Joint Surg Am 1997;79:866-73.

Patellar ligament rupture during total knee arthroplasty in an ochronotic patient

Year 2014, , 367 - 370, 30.05.2014
https://doi.org/10.3944/AOTT.2014.3245

Abstract

Ochronotic arthropathy mainly involves the spine and large joints. Along with blackening of the joint, degeneration rapidly progresses mostly in the knee, resulting in symptoms by the 4th or 5th decade. As the role of medical treatment and joint conservation surgeries are limited in the early stages, joint replacement is the only effective option in one third of patients. We present a case of the unique complication of patellar ligament rupture during total knee replacement (TKR) of an ochronotic joint. A 51-year-old male presented with bilateral severe tricompartmental osteoarthritis with varus deformities and restriction of motion. Bilateral TKR was performed. At the 28-month follow-up, the patient was walking pain free with acceptable position of implants in radiographs. To our knowledge this is the first report of rupture of the patellar ligament during TKR of an ochronotic joint. We propose appropriate preoperative preparation and greater care in the handling of the tendon during TKR of an ochronotic joint in order to avoid complication.

References

  • Groseanu L, Marinescu R, Laptoiun D, Botezatu I, Staniceanu F, Zurac S, et al. A late and difficult diagnosis of ochronosis. J Med Life 2010;3:437-43.
  • Wagner LR, Knott JL, Machaffie RA, Walsh JR. Clinical and pathological findings in ochronosis. J Clin Pathol 1960;13:22-6.
  • Aydoğdu S, Cullu E, Ozsoy MH, Sur H. Cementless total knee arthroplasty in ochronotic arthropathy: a case report with a 4-year follow-up. J Arthroplasty 2000;15:539-43.
  • Konttinen YT, Hoikka V, Landtman M, Saari H, Santavirta S, Metsärinne K, et al. Ochronosis: a report of a case and a review of literature. Clin Exp Rheumatol 1989;7:435-44.
  • Kural C, Cetinus EM, Kural A, Uğraş AA, Kaya I. Knee ochronotic arthropathy and arthroscopic findings. Acta Orthop Traumatol Turc 2009;43:67-71.
  • Raaijmaakers M, Steenbrugge F, Dierickx C. Ochronosis, arthroscopy of a black knee: a case report and review of the literature. Knee Surg Sports Traumatol Arthrosc 2008;16:182-4.
  • West JL, Keene JS, Kaplan LD. Early motion after quadriceps and patellar tendon repairs: outcomes with singlesuture augmentation. Am J Sports Med 2008;36:316-23. Khaled A, Kerkeni N, Hawilo A, Fazaa B, Kamoun MR. Endogenous ochronosis: case report and a systematic review of the literature. Int J Dermatol 2011;50:262-7.
  • Kefeli M, Tomak Y, Can B, Bariş S. Arthroplasty for the treatment of joint degeneration caused by ochronosis in two cases. Acta Orthop Traumatol Turc 2008;42:139-44. Spencer JM, Gibbons CL, Sharp RJ, Carr AJ, Athanasou NA. Arthroplasty for ochronotic arthritis: no failure of 11 replacements in 3 patients followed 6-12 years. Acta Orthop Scand 2004;75:355-8.
  • Braconi D, Bernardini G, Bianchini C, Laschi M, Millucci L, Amato L, et al. Biochemical and proteomic characterization of alkaptonuric chondrocytes. J Cell Physiol 2012;227:3333-43.
  • Manoj Kumar RV, Rajasekaran S. Spontaneous tendon ruptures in alkaptonuria. J Bone Joint Surg Br 2003;85:883-6.
  • Ando W, Sakai T, Kudawara I, Ieguchi M, Miyamoto T, Ohzono K. Bilateral achilles tendon ruptures in a patient with ochronosis: a case report. Clin Orthop Relat Res 2004;424:180-2.
  • Jebaraj I, Rao A. Achilles tendon enthesopathy in ochronosis. J Postgrad Med 2006;52:47-8.
  • Jaureguito JW, Dubois CM, Smith SR, Gottlieb LJ, Finn HA. Medial gastrocnemius transposition flap for the treatment of disruption of the extensor mechanism after total knee arthroplasty. J Bone Joint Surg Am 1997;79:866-73.
There are 13 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Case Report
Authors

Madan Mohan Sahoo This is me

Sudhir Kumar Mahapatra This is me

Gopal Chandra Sethi This is me

Sunil Kumar Dash This is me

Publication Date May 30, 2014
Published in Issue Year 2014

Cite

APA Sahoo, M. M., Mahapatra, S. K., Chandra Sethi, G., Kumar Dash, S. (2014). Patellar ligament rupture during total knee arthroplasty in an ochronotic patient. Acta Orthopaedica Et Traumatologica Turcica, 48(3), 367-370. https://doi.org/10.3944/AOTT.2014.3245
AMA Sahoo MM, Mahapatra SK, Chandra Sethi G, Kumar Dash S. Patellar ligament rupture during total knee arthroplasty in an ochronotic patient. Acta Orthopaedica et Traumatologica Turcica. May 2014;48(3):367-370. doi:10.3944/AOTT.2014.3245
Chicago Sahoo, Madan Mohan, Sudhir Kumar Mahapatra, Gopal Chandra Sethi, and Sunil Kumar Dash. “Patellar Ligament Rupture During Total Knee Arthroplasty in an Ochronotic Patient”. Acta Orthopaedica Et Traumatologica Turcica 48, no. 3 (May 2014): 367-70. https://doi.org/10.3944/AOTT.2014.3245.
EndNote Sahoo MM, Mahapatra SK, Chandra Sethi G, Kumar Dash S (May 1, 2014) Patellar ligament rupture during total knee arthroplasty in an ochronotic patient. Acta Orthopaedica et Traumatologica Turcica 48 3 367–370.
IEEE M. M. Sahoo, S. K. Mahapatra, G. Chandra Sethi, and S. Kumar Dash, “Patellar ligament rupture during total knee arthroplasty in an ochronotic patient”, Acta Orthopaedica et Traumatologica Turcica, vol. 48, no. 3, pp. 367–370, 2014, doi: 10.3944/AOTT.2014.3245.
ISNAD Sahoo, Madan Mohan et al. “Patellar Ligament Rupture During Total Knee Arthroplasty in an Ochronotic Patient”. Acta Orthopaedica et Traumatologica Turcica 48/3 (May 2014), 367-370. https://doi.org/10.3944/AOTT.2014.3245.
JAMA Sahoo MM, Mahapatra SK, Chandra Sethi G, Kumar Dash S. Patellar ligament rupture during total knee arthroplasty in an ochronotic patient. Acta Orthopaedica et Traumatologica Turcica. 2014;48:367–370.
MLA Sahoo, Madan Mohan et al. “Patellar Ligament Rupture During Total Knee Arthroplasty in an Ochronotic Patient”. Acta Orthopaedica Et Traumatologica Turcica, vol. 48, no. 3, 2014, pp. 367-70, doi:10.3944/AOTT.2014.3245.
Vancouver Sahoo MM, Mahapatra SK, Chandra Sethi G, Kumar Dash S. Patellar ligament rupture during total knee arthroplasty in an ochronotic patient. Acta Orthopaedica et Traumatologica Turcica. 2014;48(3):367-70.