Surgical management of a spontaneous black tendon rupture

Spontaneous non-traumatic rupture of Tendo-Achilles (TA) as a presenting feature of alkaptonuria is unusual. In this disorder, there is deposition of homogentisic acid in the cartilage of major joints and intervertebral disc is responsible for the degenerative changes. Infrequently, it also gets deposited in major tendons that renders them structurally weak ensuing in pathological ruptures. A case is presented with non-traumatic TA rupture and its surgical management in alkaptonuria.