{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T18:47:14Z","timestamp":1782413234028,"version":"3.54.5"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002386","name":"Cairo University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002386","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Surg Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Gunshot hip injuries present major reconstructive challenges due to contamination, retained projectiles, soft-tissue compromise, and variable bone loss. Total hip replacement (THR) in this setting carries increased risks of infection, instability, and technical failure. This study evaluated the clinical and radiological outcomes of THR following gunshot hip trauma using a structured, severity-based subclassification to inform reconstructive strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty patients with gunshot hip injuries underwent surgical debridement followed by THR, performed as single-stage or staged procedures according to injury severity, contamination, and systemic condition. Injuries were categorized into three groups: structurally benign injuries; severe or neglected injuries with major bone or soft-tissue compromise; and complex abdominopelvic traversing injuries with visceral involvement. Reconstruction predominantly used cementless acetabular components, with selective use of long femoral stems, revision cups, dual-mobility designs, and bone grafts or porous metal augments. Clinical outcomes were assessed using the Harris Hip Score (HHS) and WOMAC index, and radiological evaluation focused on component stability and graft incorporation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 30 patients were included: 11 in Group I (structurally benign injuries), 10 in Group II (severe or neglected injuries), and 9 in Group III (complex abdominopelvic traversing injuries). At a mean follow-up of 46\u2009\u00b1\u200910 (24\u201372) months, the mean Harris Hip Score (HHS) was 84\u2009\u00b1\u200910 and the mean WOMAC score was 19\u2009\u00b1\u20097. Operative complexity and blood loss increased with injury severity. Two-stage THR was required in 27% of Group I, 60% of Group II, and 100% of Group III. Radiographs demonstrated stable component fixation in all hips, with complete graft or augment incorporation within 6\u201312\u00a0months. Postoperative complications occurred in five patients, predominantly in higher-severity groups. Functional outcomes were inversely related to injury severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>THR after gunshot hip injury achieved satisfactory mid-term functional and radiological outcomes in this single-center cohort. Staged reconstruction and advanced implant strategies appear beneficial in managing complex and contaminated injuries. These findings are descriptive and intended to inform clinical decision-making; further studies are required for external validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13018-026-07037-2","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T14:48:25Z","timestamp":1782139705000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Total hip replacement after gunshot hip injuries: a severity-based clinical framework\u2014a single-centre experience"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6086-4834","authenticated-orcid":false,"given":"Mohamed","family":"Abo-Elsoud","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3925-6607","authenticated-orcid":false,"given":"Mostafa Ahmed","family":"Shawky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5700-493X","authenticated-orcid":false,"given":"Mahmoud","family":"Fahmy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"issue":"33","key":"7037_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2025.101671","volume":"26","author":"A Abialevich","year":"2025","unstructured":"Abialevich A, Tzaytlin I, Acker A, Benkovich V. Total hip arthroplasty after gunshot-related hip injuries: case series and review of literature. Arthroplast Today. 2025;26(33):101671. https:\/\/doi.org\/10.1016\/j.artd.2025.101671.","journal-title":"Arthroplast Today"},{"issue":"3","key":"7037_CR2","doi-asserted-by":"publisher","DOI":"10.1177\/2309499019873113","volume":"27","author":"O Pazarci","year":"2019","unstructured":"Pazarci O, Kilinc S, Camurcu Y, Bulut O. Total hip arthroplasty after hip joint gunshot injury. J Orthop Surg (Hong Kong). 2019;27(3):2309499019873113. https:\/\/doi.org\/10.1177\/2309499019873113.","journal-title":"J Orthop Surg (Hong Kong)"},{"issue":"1","key":"7037_CR3","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1186\/s13018-020-01993-z","volume":"15","author":"R \u00d6zden","year":"2020","unstructured":"\u00d6zden R, Davut S, Do\u011framac\u0131 Y, Kalac\u0131 A, Duman \u0130G, Uru\u00e7 V. Treatment of secondary hip arthritis from shell fragment and gunshot injury in the Syrian civil war. J Orthop Surg Res. 2020;15(1):464. https:\/\/doi.org\/10.1186\/s13018-020-01993-z.","journal-title":"J Orthop Surg Res"},{"issue":"23","key":"7037_CR4","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/j.jor.2020.12.029","volume":"30","author":"I Tisnovsky","year":"2020","unstructured":"Tisnovsky I, Katz SD, Pincay JI, Garcia Reinoso L, Redfern JAI, Pascal SC, et al. Management of gunshot wound-related hip injuries: a systematic review of the current literature. J Orthop. 2020;30(23):100\u20136. https:\/\/doi.org\/10.1016\/j.jor.2020.12.029.","journal-title":"J Orthop"},{"issue":"10","key":"7037_CR5","doi-asserted-by":"publisher","first-page":"2218","DOI":"10.1016\/j.injury.2016.06.020","volume":"47","author":"S Maqungo","year":"2016","unstructured":"Maqungo S, Hoppe S, Kauta JN, McCollum GA, Laubscher M, Held M, et al. Surgical hip dislocation for removal of retained intra-articular bullets. 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Cureus. 2024;16(10):e71648. https:\/\/doi.org\/10.7759\/cureus.71648.","journal-title":"Cureus"},{"issue":"1","key":"7037_CR10","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/S0030-5898(20)31974-X","volume":"26","author":"WT Long","year":"1995","unstructured":"Long WT, Brien EW, Boucree JB Jr, Filler B, Stark HH, Dorr LD. Management of civilian gunshot injuries to the hip. Orthop Clin North Am. 1995;26(1):123\u201331.","journal-title":"Orthop Clin North Am"},{"issue":"2","key":"7037_CR11","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1148\/radiology.156.2.4011890","volume":"156","author":"SJ Sclafani","year":"1985","unstructured":"Sclafani SJ, Vuletin JC, Twersky J. Lead arthropathy: arthritis caused by retained intra-articular bullets. 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Approval was granted by the Ethics Committee of orthopaedic department of Cairo University.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Patient gave written informed consent for their personal or clinical details along with any identifying images to be published in this study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Not applicable.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial number"}}],"article-number":"365"}}