PMC6378486_01
Preoperative radiographs: (a) Lequesne false profile view, (b) Dunn view, and (c) anteroposterior view.
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Part of the projectile was in an intra-articular position, confirmed by oblique views and computed tomography (Figures 1 and 2).
Preoperative tomography to identify the exact location of the projectile: (a) sagittal view, (b) coronal view, (c) axial view, and (D) 3D reconstruction.
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Part of the projectile was in an intra-articular position, confirmed by oblique views and computed tomography (Figures 1 and 2).
Intraoperative photo with projectile located in the intra-articular position, within the acetabular cartilage in the posterosuperior acetabulum. Full-thickness chondral lesion around the projectile. Maceration and fragmentation of the surrounding cartilage.. CA: acetabular cartilage; DA: acetabular defect; B: bullet.
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Part of the projectile protruded into the joint surface, with a full-thickness lesion of the posterosuperior acetabular cartilage, measuring approximately 3 x 2 cm (Figure 3).
Intraoperative photos without the projectile:extensive chondral defect in the acetabulum and femoral head after removal of the projectile and loose chondral fragments.. DA: acetabular defect; CA: acetabular cartilage; DF: femoral defect; CF: femoral cartilage; LA: labrum.
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After the projectile was removed, the chondral defects were extensively debrided (Figure 4).
Follow-up images: (a) AP radiograph, (b) profile radiograph, (c) coronal MRI, and (d) sagittal MRI.. Bone and chondral defects filled by nonspecific scar tissue. No signs of diffuse chondropathy and no areas of bone edema around the lesion.
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Follow-up images demonstrated no signs of hip chondrolysis, osteonecrosis, or arthritis, including a magnetic resonance imaging (MRI) exhibiting the bone and chondral defects filled by nonspecific scar connective tissue (Figure 5).