Suture Granuloma Mimicking Infection Following Total Hip Arthroplasty

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.