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Long-term follow-up of bilateral hip and knee arthroplasty secondary to ochronotic arthropathy.

ABSTRACT: Alkaptonuria is a rare metabolic disorder caused by the deficiency of homogentisic acid oxidase enzyme, which is responsible for eliminating homogentisic acid from the body through the renal system. Excessive accumulation of homogentisic acid leads to ochronosis and ochronotic arthritis. Owing to the rarity of the disease, long-term functional outcomes of joint replacements of the hips and knees in ochronosis arthropathy are unconfirmed, and only a limited number of case reports are available on this. We present a case of a 45-year-old man with ochronosis and advanced osteoarthritis of both the hips and knees. He underwent bilateral hip and knee replacements as staged procedures. At a follow-up of more than 12 years, the man had full mobility with no loosening of implants.

SUBMITTER: Ilyas I

PROVIDER: S-EPMC7303484 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Long-term follow-up of bilateral hip and knee arthroplasty secondary to ochronotic arthropathy.

Ilyas Imran I Kashif Syed S Algashiri Majed F MF Rabbani Samar A SA Aldakhil Sahar S SS Al-Mohrej Omar A OA

Arthroplasty today 20200226 2

Alkaptonuria is a rare metabolic disorder caused by the deficiency of homogentisic acid oxidase enzyme, which is responsible for eliminating homogentisic acid from the body through the renal system. Excessive accumulation of homogentisic acid leads to ochronosis and ochronotic arthritis. Owing to the rarity of the disease, long-term functional outcomes of joint replacements of the hips and knees in ochronosis arthropathy are unconfirmed, and only a limited number of case reports are available on ...[more]

PMID: 32577465

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Clinical and Surgical Insights on Bilateral Total Knee Arthroplasty in Ochronotic Arthropathy: A Case-based Review.

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| S-EPMC8930374 | biostudies-literature

Prospective quality of life assessment after hip and knee arthroplasty: short- and mid-term follow-up results.

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| S-EPMC5485233 | biostudies-literature

Total knee arthroplasty and physical therapy for arthropathy in alkaptonuria: A 4-year follow-up case report.

Project description:IntroductionAlkaptonuria is a rare autosomal recessive metabolic disorder which leads to accumulation of homogentisic acid in the body.Case presentationWe report a rare case of an alkaptonuria-related knee arthritis who underwent left total knee arthroplasty and received postoperative systematic physical therapy in a 57-year-old male patient. The patient has suffered from bilateral knee pain for over 4 years. The patient developed melanin pigmentation on the skin of the whole body, especially on the face and auricle. He self-reported that fresh urine was normal color but after standing overnight, the color deepened to black or soy color. He underwent routine urine examination for many times, but no obvious abnormality was found. The patient has suffered from low back pain for more than 20 years. He had been considered for lumbar disc herniation and ankylosing spondylitis after many in-hospital visits. After symptomatic medication, there was no obvious relief. We followed the patient for 4 years after surgery.ResultThe patient presented with pain relief and enhanced range of motion at the 4-year follow-up. The improvements of daily living and the pain relief suggest that the surgery is appropriate for this rare disease.ConclusionIt is rare that the knee pain is diagnosed as alkaptonuria. After total knee arthroplasty and physical therapy, the patient had a good outcome. This case provides experience for the diagnosis and treatment of alkaptonuria-related knee arthritis.

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Comparison of computer-assisted navigation and conventional instrumentation for bilateral total knee arthroplasty: The outcomes at mid-term follow-up.

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| S-EPMC6882567 | biostudies-literature

Knee Arthroscopy: A Diagnostic and Therapeutic Tool for Management of Ochronotic Arthropathy.

Project description:The surgical treatment of ochronotic arthropathy remains unclear. Although there is no absolute cure for ochronotic arthropathy, current management typically begins with conservative treatment. Total joint replacement may eventually be necessary for joints that become severely degenerative. Ochronotic arthropathy is present in patients with alkaptonuric ochronosis, which is characterized by dark pigmentation of connective tissue and black discoloration of urine owing to a deficiency of homogentisic acid oxidase. As a result, soft tissues become brittle and subsequently more susceptible to mechanical stress, resulting in articular cartilage degeneration. The diagnosis of ochronotic arthropathy of the knee often occurs intraoperatively after discovery of darkened synovium and black deposits during arthroscopy. The purpose of this article is to describe arthroscopic debridement as an effective treatment option and diagnostic tool for ochronotic arthropathy of the knee after failure of conservative measures.

| S-EPMC6261060 | biostudies-literature

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| S-EPMC4956687 | biostudies-literature

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Sports Activity after Low-contact-stress Total Knee Arthroplasty - A long term follow-up study.

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| S-EPMC5435341 | biostudies-literature

Effectiveness, Patient Satisfaction, and Cost Reduction of Virtual Joint Replacement Clinic Follow-Up of Hip and Knee Arthroplasty.

Project description:BackgroundTotal hip and knee arthroplasties are increasingly performed operations, and routine follow-up places huge demands on orthopedic services. This study investigates the effectiveness, patients' satisfaction, and cost reduction of Virtual Joint Replacement Clinic (VJRC) follow-up of total hip arthroplasty and total knee arthroplasty patients in a university hospital. VJRC is especially valuable when in-person appointments are not advised or feasible such as during the COVID-19 pandemic.MethodsA total of 1749 patients who were invited for VJRC follow-up for knee or hip arthroplasty from January 2017 to December 2018 were included in this retrospective study. Patients were referred to VJRC after their 6-week postoperative review. Routine VJRC postoperative review was undertaken at 1 and 7 years and then 3-yearly thereafter. We evaluated the VJRC patient response rate, acceptability, and outcome. Patient satisfaction was measured in a subgroup of patients using a satisfaction survey. VJRC costs were calculated compared to face-to-face follow-up.ResultsThe VJRC had a 92.05% overall response rate. Only 7.22% required further in-person appointments with only 3% being reviewed by an orthopedic consultant. VJRC resulted in an estimated saving of £42,644 per year at our institution. The patients' satisfaction survey showed that 89.29% of the patients were either satisfied or very satisfied with VJRC follow-up.ConclusionVJRC follow-up for hip and knee arthroplasty patients is an effective alternative to in-person clinic assessment which is accepted by patients, has high patient satisfaction, and can reduce the cost to both health services and patients.

| S-EPMC7428443 | biostudies-literature

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