Black hip: a rare case treated by total hip replacement

Ann Saudi Med. 2013 Jul-Aug;33(4):368-71. doi: 10.5144/0256-4947.2013.368.


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.

Publication types

  • Case Reports

MeSH terms

  • Alkaptonuria / complications
  • Arthroplasty, Replacement, Hip / methods*
  • Female
  • Follow-Up Studies
  • Hip Joint / pathology
  • Hip Joint / surgery*
  • Humans
  • Joint Diseases / etiology
  • Joint Diseases / pathology
  • Joint Diseases / surgery*
  • Middle Aged
  • Ochronosis / complications*
  • Ochronosis / pathology
  • Treatment Outcome