Total Knee Replacement in Alkaptonuric Ochronosis : Two Case Reports and Literature Review

Cesar Pesciallo; German Garabano; Joaquin Rodriguez; German Viale; Fernando  Tillet; Hernan Del Sel

doi:10.23750/abm.v92iS1.10439

Total Knee Replacement in Alkaptonuric Ochronosis

Two Case Reports and Literature Review

Authors

Cesar Pesciallo Department of Orthopaedic and Traumatology, Hospital Británico de Buenos Aires
German Garabano Department of Orthopaedic and Traumatology, Hospital Británico de Buenos Aires http://orcid.org/0000-0001-5936-0607
Joaquin Rodriguez Department of Orthopaedic and Traumatology, Hospital Británico de Buenos Aires https://orcid.org/0000-0002-1089-3071
German Viale Department of Orthopaedic and Traumatology, Hospital Británico de Buenos Aires
Fernando Tillet Department of Orthopaedic and Traumatology , Hospital Británico de Buenos Aires https://orcid.org/0000-0003-2658-9856
Hernan Del Sel Department of Orthopaedic and Traumatology, Hospital Británico de Buenos Aires https://orcid.org/0000-0002-3655-1408

Keywords:

alkaptonuria, ochronotic arthropathy, total knee replacement

Abstract

Background and objective: Alkaptonuria is a rare disease characterized by the accumulation of homogentisic acid (HGA). Over time, these patients may develop disabling ochronotic arthropathy. We present 2 cases of patients with end-stage arthropathy treated with total knee arthroplasty (TKA).

Methods: Both patients complained of disabling knee pain and reported limited walking distance (200-300 m). One had a history of osteotomy for medial knee arthtritis and ignored his underlying condition. The other presented with valgus gonoarthrosis and diagnosis of alkaptonuria.

Results: Intraoperatively, the characteristic dark-blue color in the joint was observed. Both patients evolved favorably after TKA with excellent results according to the Knee Society Scores (KSS) at three years of follow-up.

Conclusion: We believe TKA is the right treatment for patients with end-stage disease because it offers considerable relief from pain and allows patients to recover function.

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