First Documented Hip Replacement in a Palestinian Patient with Ochronotic Alkaptonuria Arthropathy: A Case Report

Introduction: Alkaptonuria (AKU) is a genetic disease caused by a deficiency in the homogentisate 1,2-dioxygenase enzyme. This deficiency leads to elevated levels of homogentisic acid and its oxidized form, benzoquinone acetic acid. Together, these substances lead to the bluish-black coloring of the...

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Main Authors: Saleh Shalalfa, Neveen Shalalfa, Javid Mohammadzadeh Azarabadi, Ahmed Nafiz Barakat
Format: Article
Language:English
Published: Indian Orthopaedic Research Group 2025-03-01
Series:Journal of Orthopaedic Case Reports
Subjects:
Online Access:https://jocr.co.in/wp/2025/03/01/first-documented-hip-replacement-in-a-palestinian-patient-with-ochronotic-alkaptonuria-arthropathy-a-case-report/
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author Saleh Shalalfa
Neveen Shalalfa
Javid Mohammadzadeh Azarabadi
Ahmed Nafiz Barakat
author_facet Saleh Shalalfa
Neveen Shalalfa
Javid Mohammadzadeh Azarabadi
Ahmed Nafiz Barakat
author_sort Saleh Shalalfa
collection DOAJ
description Introduction: Alkaptonuria (AKU) is a genetic disease caused by a deficiency in the homogentisate 1,2-dioxygenase enzyme. This deficiency leads to elevated levels of homogentisic acid and its oxidized form, benzoquinone acetic acid. Together, these substances lead to the bluish-black coloring of the bone and cartilage, along with calcification, inflammation, degeneration, and ultimately osteoporosis. The accumulation of pigments in the spine and major joints can result in ochronotic degenerative arthropathy. Case Report: In this study, we present the case of a 65-year-old Palestinian man who exhibited musculoskeletal manifestations of AKU for 15 years. He was successfully treated with hip replacement, and we conducted a literature analysis to provide a comprehensive summary of the etiology, clinical characteristics, and potential treatments. Conclusion: AKU affects the spine and large joints. At present, there is no cure for this condition. A diet low in Vitamin C, antioxidants, tyrosine, and phenylalanine may delay the progression of AKU, but the long-term consequences are still unknown. Joint replacement may be recommended to relieve joint pain and improve mobility.
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publishDate 2025-03-01
publisher Indian Orthopaedic Research Group
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series Journal of Orthopaedic Case Reports
spelling doaj-art-ae491bf14ba54ff5ac16cf1ef34f46cc2025-08-20T03:22:12ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-03-0115312112410.13107/jocr.2025.v15.i03.5356First Documented Hip Replacement in a Palestinian Patient with Ochronotic Alkaptonuria Arthropathy: A Case ReportSaleh ShalalfaNeveen ShalalfaJavid Mohammadzadeh AzarabadiAhmed Nafiz BarakatIntroduction: Alkaptonuria (AKU) is a genetic disease caused by a deficiency in the homogentisate 1,2-dioxygenase enzyme. This deficiency leads to elevated levels of homogentisic acid and its oxidized form, benzoquinone acetic acid. Together, these substances lead to the bluish-black coloring of the bone and cartilage, along with calcification, inflammation, degeneration, and ultimately osteoporosis. The accumulation of pigments in the spine and major joints can result in ochronotic degenerative arthropathy. Case Report: In this study, we present the case of a 65-year-old Palestinian man who exhibited musculoskeletal manifestations of AKU for 15 years. He was successfully treated with hip replacement, and we conducted a literature analysis to provide a comprehensive summary of the etiology, clinical characteristics, and potential treatments. Conclusion: AKU affects the spine and large joints. At present, there is no cure for this condition. A diet low in Vitamin C, antioxidants, tyrosine, and phenylalanine may delay the progression of AKU, but the long-term consequences are still unknown. Joint replacement may be recommended to relieve joint pain and improve mobility.https://jocr.co.in/wp/2025/03/01/first-documented-hip-replacement-in-a-palestinian-patient-with-ochronotic-alkaptonuria-arthropathy-a-case-report/ochronotic alkaptonuria arthropathyhomogentisic acidorthopedic surgeryhip arthroplasty
spellingShingle Saleh Shalalfa
Neveen Shalalfa
Javid Mohammadzadeh Azarabadi
Ahmed Nafiz Barakat
First Documented Hip Replacement in a Palestinian Patient with Ochronotic Alkaptonuria Arthropathy: A Case Report
Journal of Orthopaedic Case Reports
ochronotic alkaptonuria arthropathy
homogentisic acid
orthopedic surgery
hip arthroplasty
title First Documented Hip Replacement in a Palestinian Patient with Ochronotic Alkaptonuria Arthropathy: A Case Report
title_full First Documented Hip Replacement in a Palestinian Patient with Ochronotic Alkaptonuria Arthropathy: A Case Report
title_fullStr First Documented Hip Replacement in a Palestinian Patient with Ochronotic Alkaptonuria Arthropathy: A Case Report
title_full_unstemmed First Documented Hip Replacement in a Palestinian Patient with Ochronotic Alkaptonuria Arthropathy: A Case Report
title_short First Documented Hip Replacement in a Palestinian Patient with Ochronotic Alkaptonuria Arthropathy: A Case Report
title_sort first documented hip replacement in a palestinian patient with ochronotic alkaptonuria arthropathy a case report
topic ochronotic alkaptonuria arthropathy
homogentisic acid
orthopedic surgery
hip arthroplasty
url https://jocr.co.in/wp/2025/03/01/first-documented-hip-replacement-in-a-palestinian-patient-with-ochronotic-alkaptonuria-arthropathy-a-case-report/
work_keys_str_mv AT salehshalalfa firstdocumentedhipreplacementinapalestinianpatientwithochronoticalkaptonuriaarthropathyacasereport
AT neveenshalalfa firstdocumentedhipreplacementinapalestinianpatientwithochronoticalkaptonuriaarthropathyacasereport
AT javidmohammadzadehazarabadi firstdocumentedhipreplacementinapalestinianpatientwithochronoticalkaptonuriaarthropathyacasereport
AT ahmednafizbarakat firstdocumentedhipreplacementinapalestinianpatientwithochronoticalkaptonuriaarthropathyacasereport