Degenerative Arthritis of the Knee Secondary to Ochronosis - A Case Report

This case report describes a 42 years old man with alkaptonuric ochronosis who sustained bilateral quadriceps tendon rupture after trivial fall, necessitating surgical repair, which was done without complications. Subsequently he developed bilateral degenerative arthritis of knee joint. We offered total knee replacement to both the knee joint. Though we were expected complications related to degenerative extensor apparatus of knee, the complications were avoided by careful handling of soft tissues. At short term follow up, the clinical outcome of the patient was satisfactory. Alkaptonuric ochronosis is a rare autosomal recessive metabolic disorder resulting in a deficiency of homogentisic acid oxidase. As the disease progresses, tissue deposition of polymerized homogentisic acid eventually will lead to the progressive degeneration of all affected body systems. In the skeletal system, cervical, thoracic and lumbosacral degenerative disk disease develops, as do widespread arthritic changes in peripheral and weight-bearing joints. There is no definitive cure for alkaptonuric ochronosis, and treatment is aimed at controlling and ameliorating symptoms.