Arthroscopic Treatment of a Low-Velocity Gunshot Injury to a Primary Total Hip Arthroplasty: A Case Report

Case: An immunosuppressed 51-year-old man sustained a ballistic injury about the site of a primary total hip arthroplasty, which had been performed for osteonecrosis of the femoral head 2 years earlier. He was treated with arthroscopic debridement and irrigation, inspection of the implants, and removal of foreign bodies. Conclusion: Ballistic injury to a hip arthroplasty site with retained foreign bodies is an unusual injury. Hip arthroscopy may represent a minimally invasive treatment option for implant inspection, joint debridement, and removal of intra-articular fragments while minimizing the risk of soft-tissue complications.

[1]  J. Cavanaugh,et al.  Cost of hospitalization for firearm injuries by firearm type, intent, and payer in the United States , 2017, Injury Epidemiology.

[2]  H. Vallier,et al.  Infection and Complications After Low-velocity Intra-articular Gunshot Injuries , 2017, Journal of orthopaedic trauma.

[3]  I. Antoniac,et al.  Adverse local tissue reaction after 2 revision hip replacements for ceramic liner fracture , 2017, Medicine.

[4]  M. Laflamme,et al.  Ankle Lead Arthropathy and Systemic Lead Toxicity Secondary to a Gunshot Wound After 49 Years: A Case Report. , 2017, The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons.

[5]  R. Ceroni,et al.  Revision of ceramic fracture with ceramic-on-polyethylene in total hip arthroplasty: Medium-term results. , 2016, Injury.

[6]  S. Mannava,et al.  Arthroscopic Bullet Removal From the Central and Peripheral Compartments of the Hip Joint. , 2016, Arthroscopy techniques.

[7]  L. Whiteside,et al.  Thin-Walled Cross-Linked Acetabular Liners Need Not Exhibit Reduced Locking Strength. , 2015, Orthopedics.

[8]  J. Slover,et al.  Periprosthetic Joint Infection in Patients Receiving TNFα Antagonists. , 2014, Bulletin of the Hospital for Joint Disease.

[9]  K. Egol,et al.  Low velocity gunshot wounds result in significant contamination regardless of ballistic characteristics. , 2014, American journal of orthopedics.

[10]  A. Krag,et al.  The Effect of Anti-Tumor Necrosis Factor Alpha Agents on Postoperative Anastomotic Complications in Crohn’s Disease: a Systematic Review , 2013, Diseases of the colon and rectum.

[11]  M. Wimmer,et al.  Osteolysis around total knee arthroplasty: a review of pathogenetic mechanisms. , 2013, Acta biomaterialia.

[12]  J. Brandt,et al.  Abrasive wear and metallosis associated with cross-linked polyethylene in total hip arthroplasty. , 2013, The Journal of arthroplasty.

[13]  S. Ito,et al.  Incidence and Risk Factors for Serious Infection in Patients with Rheumatoid Arthritis Treated with Tumor Necrosis Factor Inhibitors: A Report from the Registry of Japanese Rheumatoid Arthritis Patients for Longterm Safety , 2011, The Journal of Rheumatology.

[14]  F. Shen,et al.  Wear versus Thickness and Other Features of 5-Mrad Crosslinked UHMWPE Acetabular Liners , 2010, Clinical orthopaedics and related research.

[15]  R. Vaidya,et al.  Civilian Gunshot Wounds of the Hip and Pelvis , 2010, Journal of orthopaedic trauma.

[16]  J. Usabiaga,et al.  Arthroscopic treatment of unstable total hip replacement. , 2010, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[17]  K. Ozkan,et al.  Arthroscopic bullet extraction from the hip in the lateral decubitus position , 2010 .

[18]  J. Mccarthy,et al.  The Role of Arthroscopy in Evaluation of Painful Hip Arthroplasty , 2009, Clinical orthopaedics and related research.

[19]  M. Umer,et al.  Bullet-induced synovitis as a cause of secondary osteoarthritis of the hip joint: A case report and review of literature , 2007, Journal of medical case reports.

[20]  C. Rorabeck,et al.  Wear and osteolysis around total knee arthroplasty. , 2007, The Journal of the American Academy of Orthopaedic Surgeons.

[21]  K. Fontaine,et al.  Tumor necrosis factor inhibitor therapy and risk of serious postoperative orthopedic infection in rheumatoid arthritis. , 2006, Arthritis and rheumatism.

[22]  M. Sokolowski,et al.  Systemic lead poisoning due to an intra-articular bullet. , 2005, Orthopedics.

[23]  C. Collinge,et al.  Arthroscopic bullet removal from the acetabulum. , 2005, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[24]  R. Mineo,et al.  Arthroscopic removal of a bullet embedded in the acetabulum. , 2003, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[25]  L. Moldawer,et al.  Inhibition of tumor necrosis factor‐α attenuates wound breaking strength in rats , 2000, Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society.

[26]  K. Hansraj,et al.  Gunshot wound injuries. Frequency and cost analyses in south central Los Angeles. , 1995, The Orthopedic clinics of North America.

[27]  I. M. Levy,et al.  Arthroscopic removal of entrapped debris following dislocation of a total hip arthroplasty. , 1987, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[28]  G. W. Woods,et al.  Lead intoxication and traumatic arthritis of the hip secondary to retained bullet fragments. A case report. , 1978, The Journal of bone and joint surgery. American volume.

[29]  H. M. Darlow,et al.  The mechanisms of primary infection of bullet wounds , 1967, The British journal of surgery.

[30]  K. Typovský.  [Removal of the bullet from the hip joint by medial arthrotomy]. , 1952, Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca.