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Black hip: a rare case treated by total hip replacement
Narayana Gowda1, Mohan J Kumar, Ajith K Kumar
1Dr. Narayana Gowda BS, Orthopaedics, PES Medical College, Kuppam, Chitore 517425,, Andra Pradesh, India, drnarayan999@yahoo.com.
Insights
Ochronotic arthropathy, a rare metabolic disorder, can cause severe hip joint degeneration. Total hip replacement offers a successful surgical solution for advanced cases, leading to symptom relief and implant stability.
Area of Science:
- Biochemistry
- Orthopedic Surgery
- Genetics
Background:
- Ochronotic arthropathy (Black Hip) is a rare metabolic disorder linked to amino acid metabolism.
- It presents with degenerative arthritis, ochronotic pigmentation, and dark urine.
- This condition can be underdiagnosed due to its rarity.
Observation:
- A 60-year-old female presented with progressive left hip pain.
- Diagnosis confirmed as ochronic arthritis of the left hip joint.
- Tissue confirmation preceded surgical intervention.
Findings:
- The patient underwent successful total hip replacement surgery.
- Two years post-surgery, the patient remained symptom-free.
- No signs of implant loosening were observed.
Implications:
- Early diagnosis and symptomatic management are crucial for ochronotic arthropathy.
- Advanced cases necessitate surgical intervention, such as total hip replacement.
- Understanding the role of vitamin C in amino acid metabolism may inform treatment strategies.
Background And Objective:
Ochronic arthropathy of hip (Black Hip) is a rare clinical manifestation of congenital disorder of amino acid metabolism characterized by a classic triad: (1) degenerative arthritis, (2) ochronotic pigmentation, and (3) urine that turns black on long standing or alkalinization. We report a case of ochronic arthropathy of the left hip joint that was successfully treated by total hip arthroplasty.
Design And Settings:
This is a case study conducted at PES Medical College, Andhra Pradesh, India.
Patients And Methods:
A 60-year-old female patient came with a history of progressive pain in her left hip joint for the last 8 months. She was diagnosed to be suffering from ochronic arthritis of left hip.
Results:
After tissue confirmation she was operated with total hip replacement. At the end of 2 years, the patient was symptom free without any implant loosening.
Conclusion:
Ochronotic arthropathy is a rare metabolic disorder that can be underdiagnosed many a times. Early management is only symptomatic, and advanced cases need surgical intervention. Vitamin preparations are given because of the influence of vitamin C on tyrosine and phenylalanine metabolism. In the cases of severe degenerative arthritis of hip, total hip replacement may be considered as a surgical option.
