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Black Bone


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Anyone ever seen this?  know the cause?

 

Performing TKA and upon opening the retinaculum, we could see that all the edges of the peri-articular cartilage were blue or blackish in color.  The cancellous bone also had a "dirty" or mucky brown to dirty yellow appearance.

 

I have never seen this so did some searching.  Found a japanese article that called it black bone and attributed it to minocycline use and it was also seen to stain the periodontal tissues.  I remembered from pharm that the tetracyclines can stain young children's teeth and therefore not given, but had never heard of the periarticular areas being stained as well.

 

he states he doesn't take -cyclines on a regular basis and isn't currently on any supplements.

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Minocycline.  It is a drug routinely used for acne and rheumatoid arthritis.  It causes bone to become pigmented, usually discovered during a total joint surgery.  Freaked me out the first time I saw it also. 

 

There is an article written by Dale N. Reed, et al titled, "Minocycline-induced black bone disease encountered during total knee arthroplasty" published in Orthopedics Journal May 2012. 

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Tetracycline was the most popular acne drug in the 60s and 70s.

Moms who took it had kids whose teeth had dark lines through them.

I grew up with 6 kids from one family who all had the same thing.

 

I haven't ever seen it in bone but have seen tons of dental issues from the "cycline" family.

 

Now, the concern is Crohns and CDiff for long term use of these drugs.

 

There is no such thing as a free lunch…...

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