An unusual case in total knee replacement surgery: alkaptonuric ochronosis

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ID: 309747
2025
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Abstract
Alkaptonuria is a rare autosomal recessive metabolic disorder caused by homogentisic acid oxidase deficiency, leading to the accumulation of homogentisic acid and ochronotic pigmentation in connective tissues. Although it typically presents with dark urine and arthropathy in later life, it often remains undiagnosed until advanced degenerative changes occur. We report a 54-year-old male patient who underwent total knee arthroplasty due to advanced degenerative arthritis. Intraoperatively, unexpected black pigmentation of the articular cartilage and surrounding connective tissues was observed. The patient had no previous diagnosis of alkaptonuria and was managed with postoperative metabolic evaluation, dietary advice, and follow-up. Ochronosis may remain undetected until late adulthood and can be encountered incidentally during orthopedic procedures. Awareness of this rare entity is crucial for orthopedic surgeons to ensure accurate intraoperative assessment and appropriate postoperative management.
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imported_1767010815_695271ff38b64 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Ahmet Yesevi Sarıaslan, Muhammed Ali Demir, Oğuz Temizyürek
Journal Journal of Multidisciplinary Orthopaedic Surgery
Year 2025
DOI
10.64575/c86hw049
URL
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