Total hip replacement after gunshot hip injuries: a severity-based clinical framework-a single-centre experience

Area of Science:

• Orthopedic surgery
• Trauma reconstruction
• Arthroplasty

Background:

• Gunshot hip injuries pose significant reconstructive challenges due to contamination and bone loss.
• Total hip replacement (THR) in this context carries high risks of infection, instability, and failure.

Purpose of the Study:

• Evaluate clinical and radiological outcomes of THR after gunshot hip trauma.
• Utilize a severity-based subclassification to guide reconstructive strategies.

Main Methods:

• 30 patients with gunshot hip injuries underwent debridement and THR (single or staged).
• Injuries classified into three groups based on severity and involvement.
• Reconstruction involved cementless components, with options for augmentation and specialized implants.

Main Results:

• Mean follow-up of 46 months; mean Harris Hip Score (HHS) of 84, WOMAC score of 19.
• Increased complexity and blood loss with higher injury severity.
• Stable component fixation and graft incorporation observed; complications mainly in severe groups.

Conclusions:

• THR demonstrates satisfactory mid-term functional and radiological outcomes post-gunshot hip injury.
• Staged reconstruction and advanced implants are beneficial for complex injuries.
• Findings inform clinical decisions; further validation needed.