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Hip arthroscopy: a unique inferomedial approach to bullet removal
Marco A Teloken1, Ivo Schmietd, Daniel P Tomlinson
1Faculdade Federal de Ciencias Medicas, Porto Alegre, RS, Brazil. mateloken@hotmail.com
Abstract:
Most arthroscopic approaches allow for inspection of the lateral part of the hip joint, but visualization of the medial part is difficult. This article describes the removal of a bullet lodged in the right femoral head of a 33-year-old man. By using an inferomedial arthroscopic approach, we avoided a formal arthrotomy and the disadvantages of other arthroscopic approaches, which include the need for alternate portals, the need for traction, and the risk of both articular cartilage and acetabular labrum damage. The authors believe that this case demonstrates the effective use of the inferomedial arthroscopic approach as an alternative method for removing foreign bodies.
Insights
This study presents an inferomedial arthroscopic approach for removing a bullet from the femoral head. This technique offers an effective alternative to traditional methods, minimizing risks to hip joint structures.
Area of Science:
- Orthopedic Surgery
- Minimally Invasive Procedures
- Hip Arthroscopy
Background:
- Visualization of the medial hip joint during arthroscopy is challenging with standard approaches.
- Foreign body removal in the hip joint often requires open arthrotomy or less optimal arthroscopic techniques.
- Existing arthroscopic methods carry risks of articular cartilage and acetabular labrum damage.
Observation:
- A case of a bullet lodged in the right femoral head of a 33-year-old male patient is described.
- An inferomedial arthroscopic approach was utilized for the bullet extraction.
- This approach allowed for direct visualization and removal of the foreign body.
Findings:
- The inferomedial arthroscopic approach successfully facilitated the removal of a bullet from the femoral head.
- This technique circumvented the need for a formal arthrotomy.
- The procedure avoided complications associated with other arthroscopic methods, such as the need for traction or multiple portals.
Implications:
- The inferomedial arthroscopic approach is presented as a viable and effective alternative for removing intra-articular foreign bodies in the hip.
- This method potentially reduces surgical morbidity and recovery time compared to open procedures.
- Further research may explore the broader application of this approach for various hip pathologies.