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One-stage revision arthroplasty in a patient with ochronotic arthropathy accompanied by joint infection: A case report
Authors:Xiao-Chao Wang  Xiao-Min Zhang  Wan-Ling Cai  Zhen Li  Chao Ma  Yi-Hai Liu  Qi-Lian He  Tian-Sheng Yan  Xue-Wei Cao
Abstract:BACKGROUNDOchronotic arthropathy (OcA) is a rare disease, which is caused by the accumulation of homogentisic acid in the joint. Patients with OcA have obvious joint pain and the disease progresses rapidly, eventually resulting in disability. Arthroplasty is an efficacious treatment in patients with OcA. However, when OcA patients have joint infection, is joint replacement an option? In the present report, we performed total knee arthroplasty in a patient with OcA and knee infection under the guidance of one-stage revision theory.CASE SUMMARYA 64-year-old male was referred to our hospital due to severe left knee pain with limited mobility for 2 years. On physical examination, the patient was found to have dark brown pigmentation of the sclera and auricle. Laboratory test results showed elevations in C-reactive protein level (65.79 mg/L) and erythrocyte sedimentation rate (90.00 mm/h). The patient underwent debridement of the left knee joint, during which the cartilage surface of the knee joint was found to be black-brown in color. Bacterial culture of synovial fluid revealed Achromobacter xylosoxidans. We then carried out arthroplasty under the guidance of the theory of one-stage revision. After surgery, the patient''s left knee joint pain disappeared and function recovered without joint infection.CONCLUSIONOcA accompanied by joint infection is rare. One-stage revision arthroplasty may be a treatment option for this disease.
Keywords:Ochronotic arthropathy  Arthroplasty  One-stage revision  Alkaptonuria  Homogentisic acid  Case report
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