The term osteomyelitis encompasses a wide group of infectious diseases involving the disease of the bone and/or bone marrow further extending to periosteum. It is a disturbing disease and involves a series of causative host and pathogen factors. The primary cause of this disease is usually taught to be microbiological especially Staphylococcus aureus and Staphylococcus epidermis. The diagnosis of osteomyelitis is strenuous, mainly in the early stages, and this disease is at all times complex to treat. Eradicating microorganisms and recuperating circulation in the regions involved, in the early stages have been the mainly employed treatment modalities. The case presented here is of chronic osteomyelitis with an extraoral draining sinus. Surgical debridement and oral antibiotics were considered as the treatment of choice.

Introduction: Ochronosis arthropathy (OcA) is a rare condition which may be treated with total knee arthroplasty (TKA) at the end stage. The condition is often discovered only intraoperatively and the ideal choice of TKA is unknown. Methodology: In the present study we studied 5 patients with worsening chronic bilateral mechanical knee pain had failed conservative therapy. Posterior stabilised (PS), cemented TKA and patella resurfacing was performed. Intraoperatively, collagenous structures such as the menisci and cartilage were noted to be black. Histological examination showed deposition of large amorphous brown material suggestive of ochronosis. He recovered well and underwent TKA of the contralateral knee the following year. At 2 years post index TKA, his outcome scores improved and he was satisfied. Discussion and Conclusion: With increasing TKA performed worldwide, a surgeon may eventually be surprised by the above findings once in their lifetime. However, as the pathogenesis of OcA appears to be inflammatory in nature, we suggest using cemented PS TKA with resurfacing of the patella.