Noise Characteristics in Ceramic-on-Ceramic vs. Metal-on-Polyethylene Total Hip Arthroplasty: A Comparative Study

Robinson, Patrick G; Anthony, Iain; Kumar, Sudeep; Jones, Bryn; Stark, A; Ingram, Roland

doi:10.5301/hipint.5000383

Cited by 5 publications

(2 citation statements)

References 23 publications

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“…In each evaluation, using the Hip Noise Assessment Questionnaire [27] and an interview, we asked patients whether the operated-on hip emitted noise [11]. The Hip Noise Assessment Questionnaire assessed onset of noise, frequency, precipitating activity, associated pain, variability of noise, and whether other individuals are aware of the noise, with overall evaluation on the patient’s quality of life.…”

Section: Methodsmentioning

confidence: 99%

High Risk of Neck-liner Impingement and Notching Observed with Thick Femoral Neck Implants in Ceramic-on-ceramic THA

Kim

Park

Lee

et al. 2021

Clin Orthop Relat Res

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Background Recently, impingement between the femoral stem and ceramic liner, which appears as a notch in the stem neck on radiographs, has emerged as a new complication. However, the proportion of impingement, potential risk factors, and related complications are poorly elucidated. Question/purposesIn patients who underwent ceramic-onceramic (CoC) THA and had at least 10 years of follow-up, we asked: (1) What proportion had radiographic evidence of stem neck-ceramic liner impingement (notching of the stem), and what implant design, implantation factors, or complications such as ceramic fracture or metallosis are associated with impingement? (2) How common are the complications of noise and ceramic fracture? (3) What are the radiologic changes (including fixation of femoral and acetabular components, osteolysis, and heterotopic ossification) and clinical outcomes as determined by the modified Harris hip score (mHHS) for this cohort? (4) What is the survivorship with implant revision as the endpoint and with reoperation for any reason as the endpoint after CoC THA using a thick-neck stem design? Methods Between May 2003 and April 2010, 643 patients underwent primary THA at a tertiary referral hospital. After excluding patients with metal-on-polyethylene and with ceramic-on-polyethylene implants, 621 patients were considered eligible for this study. All patients received the same hemispherical titanium cup, a standard-length tapered titanium stem, and a CoC bearing. Of those, 19% (115) were lost to follow-up before 10 years, and 8% (50) were excluded because they died before the minimum follow-up duration of 10 years, leaving 73% (456) for analysis. Patients had a mean age of 50 6 14 years and were followed for a median (range) of 13 years (10 to 17). The mean cup abduction was 38°6 5°, and the mean cup anteversion was 26°6 7°. To determine the proportion of patients with the neck-liner impingement, we analyzed the plain radiographs of every patient during follow-up to detect notches around the stem. The detection of stem neck notches on the radiographs was reliable (intraobserver reliability: k = 0.963; p < 0.001 and interobserver reliability: k = 0.975; p < 0.001). To evaluate factors related to Each author certifies that there are no commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research® neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use.

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Section: Methodsmentioning

confidence: 99%

High Risk of Neck-liner Impingement and Notching Observed with Thick Femoral Neck Implants in Ceramic-on-ceramic THA

Kim

Park

Lee

et al. 2021

Clin Orthop Relat Res

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“…Noise in total hip arthroplasty (THA) has been advanced as a more prevalent issue after the introduction of large bearing ceramic-on-ceramic (CoC) hip joints, 1,2 although similar cases have also been reported for metal-on-metal (MoM) and metal-on-polyethylene (MoP) bearings. 3,4 Noise normally affects <2% of CoC THAs, 5 but specific patients' conditions and/or prosthetic models may favor the emission of noise in up to 24.6%. 2,6,7 Although it is rarely associated with pain, 1 noise generates concern and social anxiety for the patient.…”

Section: Introductionmentioning

confidence: 99%

Squeaking and other noises in patients with ceramic-on-ceramic total hip arthroplasty

et al. 2019

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Introduction: Noise in ceramic-on-ceramic (CoC) total hip arthroplasty (THA) is a potential symptom of abnormal bearing wear. Squeaking and other prosthetic hip noises are multi-factorial phenomena that can be analysed and may provide prognostic information. Methods: 46 patients with noisy CoC bearings were investigated using X-ray, computed tomography and joint fluid analysis, and classified into either high or low risk of ceramic liner fracture groups according to previously published guidelines. Noise events from the bearings of 16 high risk cases which were subsequently revised were compared with 30 patients in the low risk control group who did not undergo revision. Noise events were analysed for their physical characteristics using a standardised protocol and classified as either low frequency and short duration ‘clicking’ or long duration and high frequency ‘squeaking’. Results: The peak frequency of squeaking during forward walking was significantly higher for patients in the case group who were revised, compared with the control group. The patient-reported onset of squeaking (46 months postoperatively) was earlier than short-noise emissions (82 months). In the standardised sequence of movements, short-noise always occurred more frequently than squeaking. Small heads (28 mm) were more likely to develop short-noise, while large heads (⩾32 mm) were more likely to develop squeaking. Discussion: Noise evaluation may provide additional value for predicting failure of CoC bearings, though some questions should be better investigated in a dedicated prospective trial.

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Alumina ceramic-on-ceramic hybrid total hip arthroplasty. A median of 15 years follow-up

Farhan-Alanie

Hrycaiczuk

Tinning

et al. 2021

Eur J Orthop Surg Traumatol

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Noise Characteristics in Ceramic-on-Ceramic vs. Metal-on-Polyethylene Total Hip Arthroplasty: A Comparative Study

Cited by 5 publications

References 23 publications

High Risk of Neck-liner Impingement and Notching Observed with Thick Femoral Neck Implants in Ceramic-on-ceramic THA

High Risk of Neck-liner Impingement and Notching Observed with Thick Femoral Neck Implants in Ceramic-on-ceramic THA

Squeaking and other noises in patients with ceramic-on-ceramic total hip arthroplasty

Alumina ceramic-on-ceramic hybrid total hip arthroplasty. A median of 15 years follow-up

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