Gouty Tophi Surrounding the Nonabsorbable Sutures of an Achilles Tendon Repair Surgical Site: A Case Report.

The formation of gouty tophi surrounding the prior surgical site years after an Achilles tendon repair is an extremely rare presentation for which only three previous cases have been documented in the literature. In this case, we report the presentation of a 53-year-old male who had an Achilles tendon repair two and a half years prior and no clinical history of gout, yet during the necessary revision procedure of his Achilles tendon, he was found to have gouty tophi surrounding the nonabsorbable sutures used during his initial surgical repair. This case presentation and the three prior ones all involve the use of nonabsorbable sutures, and these sutures may potentially serve as a nidus for the formation of gouty tophi years after a surgical procedure, even in patients who do not have a clinical history of gout. It is important for clinicians to be aware of this rare clinical presentation as potential sequelae include infectious processes and the need for revision procedures.