Patellar ligament rupture during total knee arthroplasty in an ochronotic patient

Ochronotic arthropathy mainly involves the spine and large joints. Along with blackening of the joint, degeneration rapidly progresses mostly in the knee, resulting in symptoms by the 4th or 5th decade. As the role of medical treatment and joint conservation surgeries are limited in the early stages, joint replacement is the only effective option in one third of patients. We present a case of the unique complication of patellar ligament rupture during total knee replacement (TKR) of an ochronotic joint. A 51-year-old male presented with bilateral severe tricompartmental osteoarthritis with varus deformities and restriction of motion. Bilateral TKR was performed. At the 28-month follow-up, the patient was walking pain free with acceptable position of implants in radiographs. To our knowledge this is the first report of rupture of the patellar ligament during TKR of an ochronotic joint. We propose appropriate preoperative preparation and greater care in the handling of the tendon during TKR of an ochronotic joint in order to avoid complication.