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Septic Arthritis of the Hip and Intrapelvic Abscess Following Intra-Articular Injection of Hylan G-F 20A Case Report
Saam Morshed, MD1; G. Russell Huffman, MD, MPH1; Michael D. Ries, MD1
1 Department of Orthopaedic Surgery, University of California at San Francisco, 500 Parnassus Avenue (MU 320-W), San Francisco, CA 94143. E-mail address for S. Morshed: saam_morshed@sbcglobal.net. E-mail address for G.R. Huffman: gruhu2@yahoo.com. E-mail address for M.D. Ries: riesm@orthosurg.ucsf.edu
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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.
Investigation performed at the Department of Orthopaedic Surgery, University of California at San Francisco, San Francisco, California

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2004 Apr 01;86(4):823-826
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Since the results of intra-articular injections of corticosteroid and local anesthetic for the treatment of rheumatoid arthritis were published1, these injections have been used to treat symptoms of degenerative arthritis that are refractory to more conservative modalities. In the past decade, on the basis of evidence showing improvement in patients with osteoarthritis of the knee, viscosupplementation with hyaluronic acid and cross-linked hyaluronans was approved by the United States Food and Drug Administration as a medical device for use in the treatment of osteoarthritis2. However, the Food and Drug Administration has not approved the use of viscosupplementation in the hip. We report a case of septic arthritis of the hip with an intrapelvic abscess following injections of corticosteroid and hylan G-F 20 (Synvisc) for symptomatic treatment of advanced degenerative arthritis of the hip secondary to osteonecrosis. The patient was informed that data concerning the case 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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