Okronotik artropatide sementsiz total diz artroplastisi uygulaması

Alkaptonüri, homogentisik asit oksidaz enziminin eksikliğiyle giden otozomal resesif geçişli metabolik bir hastalıktır. HGA metabolitlerinin konnektif dokularda birikmesi sonucu okronozis ortaya çıkar. Bu yazıda, diz ve bel ağrısı sebebiyle kliniğimize başvuran , yapılan fizik ve radyolojik muayene sonucu diz osteoartriti tanısı alarak sementsiz total diz artroplastisi planlanan, operasyon sırasında, diz ekleminde kıkırdak ve çevre konnektif dokulardaki kahverengi-siyah renk değişiminin fark edildiği ve alınan patoloji örneğinin okronozisle uyumlu geldiği bir olgu anlatılmıştır.

Cementless total knee arthroplasty for ochronotıc arthropathy

Alkaptonuria is an autozomal recessive metabolic disease that goes with the deficiency of homogentisic acid oxidase. Collection of the metabolits of HGA in connective tissues results ochronosis. In this article, we discuss a patient who came to us with backache and knee pain. After physical and radiological examination we planned a cementless total knee arthroplasty. Intraoperatively, we recognized the brown-black colour in the soft tissues. The pathological analysis matched with ochronosis.

___

  • 1) Thacker M, Garude S and Puri A. Ochronotic Arthropathy: Arthroscopic Findings in the Shoulder and the Knee. The Journal of Arthroscopic and Related Surgery 2003;19:14-7
  • 2) Burkhart CG, eMedicine Article — Ochronosis
  • 3) Keller J. M., Macaulay W„ Nercessian O. A.,Jaffe I A. Rheumatol Int (2005) 25:81-85
  • 4) Ramsperger R, Lubinus HH. Alkaptonurie und ochronotische Arthropathie. Chirurg 1994;65:1061-5
  • 5) N.Hamdi, T.D.V: Cooke, B. Hassan. Ochronotic arthropathy:case report and review of the literature. International Orthopaedics (SICOT) 1999; 23: 122-125
  • 6) Aydoğdu S, Cullu E, Özsoy MH, Sur H. Cementless Total Knee Arthroplasty in Ochronotic Arthropathy. The Journal of Arthroplasty 2000;15:539-543
  • 7) Cetinus E, Cever I, Kural C, Erturk H, Akyildiz M. Ochronotic arthritis: case reports and review of the literature. Rheumatol Int 2005;25:465-8
  • 8) Demir S. Alkaptonurie ochronosis: a case with multiple joint replacement arthroplasties. Clin Rheumatol 2003;22:437-9
  • 9) Keller J, Macaulay W, Nercessian O, Israeli J.New developments in ochronosis: review of the literature.Rheumatol Int 2005;25:81-85
  • 10) Şahin G, Milcan A, Bağış S, Köktürk A, Pata C, Erdoğan C. A case of ochronosis: upper extremity involvement. Rheumatol Int 2001;21:78-80
  • 11) Kottinen YT, Hoikka V: Ochronosis Clin Exp Rheumatol 7:435, 1989
  • 12) Selvi E, Manganelli S, Mannoni A, Benu-cci M, Minacci C, Marcolongo R. Chronic Ochronotic Arthritis: Clinical, Arthroscopic, and Pathologic F indings. The Journal of Rheumatology 2000;27:2272-4