Ochronotic Knee Arthropathy: A rare cause of arthritic knee pain and literature review of surgical considerations during knee arthroplasty

Gaurav Govil,Lavindra Tomar,Pawan Dhawan

doi:10.18231/j.ijor.2020.021

Abstract

Ochronotic Knee Arthropathy: A rare cause of arthritic knee pain and literature review of surgical considerations during knee arthroplasty - IJOR- Print ISSN No: - 2581-8112 Online ISSN No:- 2581-9151 Article DOI No:- 10.18231/j.ijor.2020.021, IP International Journal of Orthopaedic Rheumatology-IP Int J Orthop Rheumat

Highlights

Knee osteoarthritis is a common disabling affection in the elderlies
A rare autosomal recessive metabolic disorder like alkaptonuria may often cause significant knee pain. 1–5 The deficiency of the enzyme homogentisic acid oxidase leads to accumulation of homogentisic acid, an intermediary in metabolism of phenylalanine and tyrosine 4,6,7 It affects one in 250,000 to 1,000,000 individuals.[2,3]
The deposition of oxidized homogensitate pigments in connective tissues affects the articular cartilages. 1,3 It leads to chronic inflammation, degeneration, and eventually arthritis. 1,3 Patients with alkaptonuria usually do not show any symptoms and about fifty percent develop ochronotic arthritis

Summary

Introduction

Knee arthritis is a common cause of chronic knee pain and disability in adults and elderly. Degenerative osteoarthritis, rheumatoid or gouty arthritis are common causes of knee arthropathy. Conservative strategies to manage knee arthropathy include pain relief measures using non-steroidal anti-inflammatory medications, life style modifications, intraarticular injections, strengthening exercises and braces. A rare autosomal recessive metabolic disorder like alkaptonuria may often cause significant knee pain. 1,3 Patients with alkaptonuria usually do not show any symptoms and about fifty percent develop ochronotic arthritis. When significant degenerative arthritis occurs, arthroplasty gives excellent outcomes comparable to osteoarthritis. A case of knee pain in a 65-year-old male incapacitated by arthritis of both knees with poor response to conservative measures is presented. A non-responder to conservative measures required simultaneous bilateral knee arthroplasty for relief from his persistent disabling knee pain

Case Report

Discussion

Conclusion