Case Report
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Alkaptonurik ocronosisde total diz artroplastisi: bir vaka raporu

Year 2026, Volume: 9 Issue: 1, 253 - 255, 05.01.2026
https://doi.org/10.32322/jhsm.1786236
https://izlik.org/JA57YK83RD

Abstract

Olgu: Her iki dizde ağrı ve fonksiyonel kısıtlılık şikayetiyle hastanemize başvuran 65 yaşında erkek hasta; preop Alkaptonuri teşhisi konmadan klasik Kellgren-Lawrence sınıflamasına göre grade IV osteoartroz olarak değerlendirilerek total diz artroplasti tedavisi uygulanmıştır. Alkaptonuri teşhisi cerrahi sırasında alınan biopsi materyalerinin incelenmesi ile post op dönemde konulmuştur. Alkaptonüri, yavaş ilerlemesi nedeniyle genellikle geç teşhis edilir. Büyük eklem artriti ile başvuran genç hastalarda, ocronozis tanısı için şüphelenilmelidir.İleri düzey ocronotik artrozda, total eklem replasman tedavisi ile başarılı sonuçlar alınabilmektedir.

References

  • Rajkumar N, Soundarrajan D, Dhanasekararaja P, Rajasekaran S. Clinical and radiological outcomes of total joint arthroplasty in patients with ochronotic arthropathy. Eur JOrthop Surg Traumatol. 2020;30(5): 923-929. doi:10.1007/s00590-020-02651-0
  • Abimbola O, Hall G, Zuckerman JD. Degenerative arthritis of the knee secondary to ochronosis. Bull NYU Hosp Jt Dis. 2011;69(4):331-334.
  • 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):e16837. doi:10. 1097/MD.0000000000016837
  • Lazaro JS, Lutz R, Deirmengian GK. Bilateral patellar tendon rupture following total knee arthroplasty in a patient with alkaptonuria: a case report. Cureus. 2023;15(5):e38597. doi:10.7759/cureus.38597
  • Rocchi V, Shapiro B, Fraser MR. An osteochondral allograft in a patient with ochronosis: a case report. JBJS Case Connect. 2018;8(3):e55. doi:10.2106/JBJS.CC.18.00038
  • Pesciallo C, Garabano G, Rodriguez J, Viale G, Tillet F, Del Sel H. Total knee replacement in alkaptonuric ochronosis. Acta Biomed. 2022;93(S1): e2022108. doi:10.23750/abm.v92iS1.10439
  • Couto A, Sá Rodrigues A, Oliveira P, Seara M. Ochronotic arthropathy-a rare clinical case. Oxf Med Case Reports. 2018;2018(9):omy069. doi:10. 1093/omcr/omy069
  • Akar B, Ugur F, Yucel MO, Aytug F. Effect of potential risk factors on renal functions in simultaneous bilateral total knee arthroplasty. Front Surg. 2024;11:1405487. doi:10.3389/fsurg.2024.1405487
  • Gruber HE, Hanley EN Jr. Alkaptonuria-associated changes in disc degeneration: a case report. JBJS Case Connect. 2015;5(4):e96. doi:10. 2106/JBJS.CC.O.00080
  • Kumps C, Stanovici J, Chaibi E, Campos-Xavier B, Pavlidou DC, Tran C. Black cartilage: incidentally discovered articular ochronosis during arthroplasty. J Inherit Metab Dis. 2021;44(6):1503-1504. doi:10.1002/jimd.12417
  • Wu L, Hu Y. Total knee arthroplasty and physical therapy for arthropathy in alkaptonuria: a 4-year follow-up case report. Front Surg. 2023;9:913120. doi:10.3389/fsurg.2022.913120
  • Kang HW, Kim M, Oh JY, Youn C. Black bone disease: ochronotic arthritis detected during knee arthroplasty. J Bone Metab. 2023;30(3): 283-287. doi:10.11005/jbm.2023.30.3.283
  • Liu Y, Li C, Zhang Z, Lu X, Zhang H. Ochronotic arthropathy effectively treated with total hip and total knee arthroplasty: a case report. Front Med (Lausanne). 2023;10:1212580. doi:10.3389/fmed.2023.1212580
  • Patel VG. Total knee arthroplasty in ochronosis. Arthroplast Today. 2015;1(3):77-80. doi:10.1016/j.artd.2015.03.003
  • Al-Ajlouni JM, Alisi MS, Yasin MS, et al. Long-term outcomes of the knee and hip arthroplasties in patients with alkaptonuria. Arthroplast Today. 2020;6(4):689-693. doi:10.1016/j.artd.2020.07.037

Total knee arthroplasty in alkaptonuric ochronosis: a case report

Year 2026, Volume: 9 Issue: 1, 253 - 255, 05.01.2026
https://doi.org/10.32322/jhsm.1786236
https://izlik.org/JA57YK83RD

Abstract

A 65-year-old male patient presented to our hospital with complaints of bilateral knee pain and functional limitation. Without a preoperative diagnosis of alkaptonuria, the patient was evaluated as grade IV osteoarthrosis according to the classical Kellgren Lawrence classification, and total knee arthroplasty was performed. The diagnosis of alkaptonuria was established in the postoperative period by examination of biopsy materials obtained during surgery. Alkaptonuria is generally diagnosed late due to its slow progression. In young patients presenting with large joint arthritis, ochronosis should be suspected as a possible diagnosis. In advanced ochronotic arthrosis, successful outcomes can be achieved with total joint replacement therapy.

References

  • Rajkumar N, Soundarrajan D, Dhanasekararaja P, Rajasekaran S. Clinical and radiological outcomes of total joint arthroplasty in patients with ochronotic arthropathy. Eur JOrthop Surg Traumatol. 2020;30(5): 923-929. doi:10.1007/s00590-020-02651-0
  • Abimbola O, Hall G, Zuckerman JD. Degenerative arthritis of the knee secondary to ochronosis. Bull NYU Hosp Jt Dis. 2011;69(4):331-334.
  • 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):e16837. doi:10. 1097/MD.0000000000016837
  • Lazaro JS, Lutz R, Deirmengian GK. Bilateral patellar tendon rupture following total knee arthroplasty in a patient with alkaptonuria: a case report. Cureus. 2023;15(5):e38597. doi:10.7759/cureus.38597
  • Rocchi V, Shapiro B, Fraser MR. An osteochondral allograft in a patient with ochronosis: a case report. JBJS Case Connect. 2018;8(3):e55. doi:10.2106/JBJS.CC.18.00038
  • Pesciallo C, Garabano G, Rodriguez J, Viale G, Tillet F, Del Sel H. Total knee replacement in alkaptonuric ochronosis. Acta Biomed. 2022;93(S1): e2022108. doi:10.23750/abm.v92iS1.10439
  • Couto A, Sá Rodrigues A, Oliveira P, Seara M. Ochronotic arthropathy-a rare clinical case. Oxf Med Case Reports. 2018;2018(9):omy069. doi:10. 1093/omcr/omy069
  • Akar B, Ugur F, Yucel MO, Aytug F. Effect of potential risk factors on renal functions in simultaneous bilateral total knee arthroplasty. Front Surg. 2024;11:1405487. doi:10.3389/fsurg.2024.1405487
  • Gruber HE, Hanley EN Jr. Alkaptonuria-associated changes in disc degeneration: a case report. JBJS Case Connect. 2015;5(4):e96. doi:10. 2106/JBJS.CC.O.00080
  • Kumps C, Stanovici J, Chaibi E, Campos-Xavier B, Pavlidou DC, Tran C. Black cartilage: incidentally discovered articular ochronosis during arthroplasty. J Inherit Metab Dis. 2021;44(6):1503-1504. doi:10.1002/jimd.12417
  • Wu L, Hu Y. Total knee arthroplasty and physical therapy for arthropathy in alkaptonuria: a 4-year follow-up case report. Front Surg. 2023;9:913120. doi:10.3389/fsurg.2022.913120
  • Kang HW, Kim M, Oh JY, Youn C. Black bone disease: ochronotic arthritis detected during knee arthroplasty. J Bone Metab. 2023;30(3): 283-287. doi:10.11005/jbm.2023.30.3.283
  • Liu Y, Li C, Zhang Z, Lu X, Zhang H. Ochronotic arthropathy effectively treated with total hip and total knee arthroplasty: a case report. Front Med (Lausanne). 2023;10:1212580. doi:10.3389/fmed.2023.1212580
  • Patel VG. Total knee arthroplasty in ochronosis. Arthroplast Today. 2015;1(3):77-80. doi:10.1016/j.artd.2015.03.003
  • Al-Ajlouni JM, Alisi MS, Yasin MS, et al. Long-term outcomes of the knee and hip arthroplasties in patients with alkaptonuria. Arthroplast Today. 2020;6(4):689-693. doi:10.1016/j.artd.2020.07.037
There are 15 citations in total.

Details

Primary Language English
Subjects Orthopaedics
Journal Section Case Report
Authors

Bedrettin Akar 0000-0001-7461-1777

Yusuf Öztürkmen 0000-0002-2199-2411

Mehmet Bülent Balıoğlu 0000-0001-5127-2004

Murat Erkek 0009-0002-3268-0592

Selim Harmanşa 0000-0003-1772-186X

Submission Date September 18, 2025
Acceptance Date December 3, 2025
Publication Date January 5, 2026
DOI https://doi.org/10.32322/jhsm.1786236
IZ https://izlik.org/JA57YK83RD
Published in Issue Year 2026 Volume: 9 Issue: 1

Cite

AMA 1.Akar B, Öztürkmen Y, Balıoğlu MB, Erkek M, Harmanşa S. Total knee arthroplasty in alkaptonuric ochronosis: a case report. J Health Sci Med / JHSM. 2026;9(1):253-255. doi:10.32322/jhsm.1786236

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