Long-Term Outcomes of the Knee and Hip Arthroplasties in Patients with Alkaptonuria

• Published in: Arthroplasty today Vol. 6; no. 4; pp. 689 - 693
• Main Authors: Al-Ajlouni, Jihad M., Alisi, Mohammed S., Yasin, Mohamad S., Khanfar, Aws, Hamdan, Mohammad, Halaweh, Ahmad Abu, Al Hawamdeh, Hashem, Tayyem, Mohammed, Alsbou, Mohammad S.
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.12.2020; Elsevier
• Subjects: Alkaptonuria; Arthroplasty; Arthroplasty in Patients with Rare Condition; Hip replacement; Knee replacement; Ochronosis; Arthroplasty; Knee replacement; Alkaptonuria; Hip replacement; Ochronosis
• ISSN: 2352-3441; 2352-3441
• DOI: 10.1016/j.artd.2020.07.037

Alkaptonuria is a rare autosomal recessive metabolic disorder. It is characterized by the accumulation of homogentisic acid in the body due to a lack of enzymes that degrade it. Over time, it results in joint degeneration and eventually leads to ochronosis. Ochronosis refers to bluish-black discoloration of connective and other tissues within the body. In this study, we present 5 distinct cases diagnosed with alkaptonuria. They have undergone 8 total joint replacement surgeries (4 hips and 4 knees) within 8 years (2010-2018). All patients had an excellent outcome over several years. The follow-up period ranged from 2 to 10 years. Although none of the presented cases had intraoperative or postoperative adverse sequelae, we must take care when dealing with patients with ochronotic arthropathy. They carry a higher risk of complications than other patients with osteoarthritis disease. These complications include fractures due to fragile bone quality, muscle or tendon rupture, joint instability, and anesthesia-related complications. Total joint arthroplasty is a valid and safe option in the management of hip and knee ochronotic arthropathy.