Arthroscopic removal of a bullet embedded in the acetabulum.

Abstract

A unique case is described involving the arthroscopic removal of a bullet in the wall of the acetabulum from a low-velocity gunshot wound. The projectile entered the abdomen anteriorly and penetrated the urinary bladder and the inner wall of the acetabulum before becoming embedded intra-articularly in the subchondral bone of the hip joint. After surgical repair of the viscus, the bullet was retrieved from the hip joint using standard arthroscopic portals and a fracture table. Postoperatively, the patient immediately resumed full weightbearing with minimal discomfort and no formal rehabilitation. No complications were encountered. Arthroscopy allowed adequate inspection of the articular surface, irrigation of the joint, and removal of the foreign body while avoiding an invasive arthrotomy with its associated morbidity and soft tissue disruption.