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Suture Granuloma Mimicking Infection Following Total Hip Arthroplasty A Report of Three Cases
Samia Sayegh, MD; Louis Bernard, MD; Richard Stern, MD; Jean-Claude Pache, MD; Ildiko Szalay, MD; Pierre Hoffmeyer, MD
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Investigation performed at the Orthopaedic and Pathology Services, University Hospital of Geneva, Geneva, Switzerland

Samia Sayegh, MD
Louis Bernard, MD
Richard Stern, MD
Jean-Claude Pache, MD
Ildiko Szalay, MD
Pierre Hoffmeyer, MD
Clinique d'Orthopédie et de Chirurgie de l'Appareil Moteur, Hópital Cantonal Universitaire, 24, rue Micheli-du-Crest, 1211 Geneva 14, Switzerland. E-mail: richard.stern@hcuge.ch

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

J Bone Joint Surg Am, 2003 Oct 01;85(10):2006-2009
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Extract

Surgical suture material is usually inert and nontoxic and causes minimal inflammation of tissue. It is not ordinarily a source of infection. We report on three patients in whom an apparent infection developed at six, eight, and nine weeks following total hip arthroplasty. All three patients presented in the same manner. Each had signs and symptoms of a wound infection (i.e., pain, erythema, induration, and local tenderness with or without seropurulent drainage) as well as an elevated erythrocyte sedimentation rate and C-reactive protein level and hypereosinophilia after closure of the wound with Vicryl suture material (polyglactin 910; Johnson and Johnson International, Brussels, Belgium). In this report, we summarize the characteristics of all three patients ( Table I ) and present our most recent case in detail. Our patients were informed that data concerning their cases would be submitted for publication.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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