İki olguda okronozise bağlı eklem dejenerasyonunda artroplasti uygulamaları

Okronozis homogentisik asit oksidaz enziminin eksikliğine bağlı oluşan ve nadir görülen bir metabolik hastalıktır. Yaşın ilerlemesiyle, eklem kıkırdağında meydana gelen pigmente homogentisik asit birikimi okronotik osteoartritle sonuçlanır. Bu yazıda, birinde iki taraflı kalça, diğerinde iki taraflı diz eklemlerini tutan okronozis nedeniyle total kalça ve diz artroplastisi uygulanan 55 ve 60 yaşlarında iki kadın hasta sunuldu. Artroplasti her bir hastada iki seanslı olarak çimentosuz (kalça) ve çimentolu (diz) uygulandı. Hastaların son ameliyattan sonra 12. aydaki (kalça) ve 10. aydaki (diz) kontrollerinde önemli yakınmaları yoktu. Düz grafilerde protez komponentlerinde anormal görünüm izlenmedi. Ameliyatta çıkarılan örneklerin histopatolojik incelemesinde, özellikle kıkırdak dokusunda olmak üzere, bağ dokusunda kahverengi-siyah renkte pigment birikimi izlendi.

Anahtar Kelimeler:

Okronoz, Artroplasti, replasman, kalça, Kadın, Eklem hastalıkları, Artroplasti, replasman, diz, Tedavi sonucu, Orta yaşlı

Arthroplasty for the treatment of joint degeneration caused by ochronosis in two cases

Ochronosis is a rare metabolic disease caused by the deficiency of the homogentisic acid oxidase enzyme. With increasing age, accumulation of pigment deposits of homogentisic acid in the joint cartilage results in ochronotic osteoarthritis. We presented two female patients, with ages 55 and 60 years, who underwent staged bilateral uncemented total hip and bilateral cemented total knee arthroplasty, respectively, for osteoarthritis caused by ochronosis. Both patients had no significant complaints at final follow-up examinations made 12 months and 10 months after the second operation in the hip and knee, respectively. Plain radiographs did not show any abnormality in the components of the prostheses. Histopathologic examination of surgical specimens showed brown-black pigment deposits in the connective tissue and cartilage tissue.

Keywords:

Ochronosis, Arthroplasty, Replacement, Hip, Female, Joint Diseases, Arthroplasty, Replacement, Knee, Treatment Outcome, Middle Aged,

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