Rupture of a black tendon: ochronotic tendo–Achilles rupture

Prakash, Vishwa; Boston, DA; Packer, Greg; Raza, Syed Atif

doi:10.1016/s0958-2592(02)00076-7

Cited by 5 publications

(5 citation statements)

References 5 publications

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“…There is no standard method for repairing the tear because the torn ends can be ragged due to extensive degeneration and are not ideal for neat suturing, and most notably, there is a gap length after the excision of the frayed ends. Therefore, several surgical techniques have been utilized for the management of ochronotic Achilles tendon rupture [ 22 ], such as direct repair, V-Y advancement, tendon transfer, the Lindholm double facial flap technique, and the Bosworth technique after the removal of the discolored part of the tendon [ 10 , 12 , 14 , 15 , 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Rupture of the Achilles tendon is reported in the literature as a rare clinical complication usually occurring in male patients with alkaptonuria [ 12 , 13 ]. To our knowledge, the first case was reported in 2003 [ 14 ]. However, very few cases have been reported in female patients with alkaptonuria [ 15 , 16 ], and the majority of the articles describe an isolated tendon rupture.…”

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confidence: 99%

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Alkaptonuria with extensive ochronotic degeneration of the Achilles tendon and its surgical treatment: a case report and literature review

et al. 2021

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Background Alkaptonuria is a rare genetic metabolic disorder due to deficiency of homogentisate 1,2-dioxygenase (HGD), an enzyme catalyzing the conversion of homogentisate to 4-maleylacetoacetate in the pathway for the catabolism of phenylalanine and tyrosine. HGD deficiency results in accumulation of homogentisic acid and its pigmented polymer. Ochronosis is a bluish-black discoloration due to the deposition of the polymer in collagenous tissues. Extensive ochronotic involvement of the Achilles tendon in alkaptonuria and its surgical treatment is rarely reported. Case report A 43-year-old man presented to our clinic in March 2019 with sudden onset of left Achilles tendon pain with no history of prior trauma. Surgical exploration revealed a complete disruption of the tendon at its attachment to the calcaneus. Black pigmentation was extensive and reached the calcaneal tuberosity, extending about 7 cm from the insertion. Discussion Achilles reconstruction was performed using flexor hallucis longus tendon transfer. The patient experienced uncomplicated healing with satisfactory functional results. Conclusion Orthopedic surgeons should be aware of the progressive nature of alkaptonuria. Extensive degenerative changes of the ruptured tendon should be suspected so that physicians can plan tendon repair and facilitate prompt surgical intervention.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Alkaptonuria with extensive ochronotic degeneration of the Achilles tendon and its surgical treatment: a case report and literature review

et al. 2021

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“…1,2 This weakens the connective tissue, leading to rupture of tendons and early degeneration of the cartilage. 3,4 The most reported tendon rupture is the tendo-Achilles.…”

Section: Discussionmentioning

confidence: 99%

“…There are only a few reports in the literature of multiple rupture of the Achilles tendon. [1][2][3][4] We report a case who had a rupture of the Achilles tendon, followed by rupture of the quadriceps tendon one year later. …”

Section: Introductionmentioning

confidence: 99%

Sequential tendon ruptures in ochronosis: case report

Kumar

2017

Int J Res Orthop

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<p>Alkaptonuria is a rare autosomal recessive disorder characterised by the absence of homogentisic acid oxidase, due to deficiency of an enzyme that degrades HGA in the tyrosine degradation pathway. Homogentisic acid (HGA) and its metabolites accumulate in the connective tissues leading to dark pigmentation of connective tissue in patients with alkaptonuria. HGA deposits in connective tissue causes weakness of the tendon and subsequent rupture, especially the large tendons in the body. Only few cases are reported in the literature with multiple tendon rupture but many case reports are available with isolated rupture of tendons. We report on a patient with sequential tendon ruptures in a patient. The case is reported for its rarity.</p>

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“…We identified 54 articles and four abstracts 2–59 . These covered a total of 339 patients, to which we added one case of our own.…”

Section: Methodsmentioning

confidence: 99%