Squeaking in fourth-generation ceramic-on-ceramic total hip replacement and the relationship with prosthesis brands: meta-analysis and systematic review

Zhao, Chenchen; Qu, Guohui; Yan, Shigui; Cai, Xun-Zi

doi:10.1186/s13018-018-0841-y

Cited by 14 publications

(18 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The percentage of patients who reported squeaking was 12%, which is within the range available from previous studies [6,41,53]. In the future, multicenter studies with large sample sizes or studies based on national databases may be able to further confirm our findings.…”

Section: Percentage Of Patients Reporting Squeakingsupporting

confidence: 87%

“…Some studies have shown that specific implants may be more likely to be associated with squeaking, possibly because of their anatomic design [15,40,44,53]. Because of the availability of prostheses for the index surgery, we mixed and matched implants from different manufacturers (combination of the Corail stem and Betacup).…”

Section: Characteristics Of Squeaking and Association Between Squeaki...mentioning

confidence: 99%

See 1 more Smart Citation

A Nomogram That Characterizes a Patient’s Odds of Developing Squeaking After Fourth-generation Ceramic-on-ceramic THA

Niu

et al. 2023

Clin Orthop Relat Res

View full text Add to dashboard Cite

Background Although ceramic-on-ceramic (CoC) bearings result in the lowest wear rate of any bearing combination, postoperative squeaking remains worrisome. However, data concerning squeaking in long-term follow-up studies are still lacking, especially for fourth-generation CoC THA. Questions/purposes (1) After keeping the prosthesis in place for 10 years, what percentage of patients treated with fourth-generation CoC THA implants report squeaking, and are there points in time when squeaking occurs more frequently? (2) What are the characteristics, association with hip function, and factors associated with squeaking? (3) Can we create a nomogram that characterizes a patient's odds of experiencing squeaking based on the factors associated with it? Methods Between January 2009 and December 2011, 1050 patients received primary THAs at our institution, 97% (1017) of whom received fourth-generation CoC THAs because this was the preferred bearing during this period. Of the 1017 eligible patients, 5% (54) underwent THAs performed by low-volume surgeons, 3% (30) were implanted with cemented prostheses, 2% (22) died, 1%One author (JF) has received funding from the National Natural Science Foundation of China (grant number 82102585) and Military Medical Science and Technology Youth Training Project (grant number 21QNPY110). One author (CX) has received funding from the National Natural Science Foundation of China (grant number 82002323). 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. Ethical approval for this study was obtained from the ethical review board of the Chinese PLA General Hospital (No. 2021-343).

show abstract

Section: Percentage Of Patients Reporting Squeakingsupporting

confidence: 87%

Section: Characteristics Of Squeaking and Association Between Squeaki...mentioning

confidence: 99%

A Nomogram That Characterizes a Patient’s Odds of Developing Squeaking After Fourth-generation Ceramic-on-ceramic THA

Niu

et al. 2023

Clin Orthop Relat Res

View full text Add to dashboard Cite

show abstract

“…Squeaking or clicking is another complication, though not specific for CoC articulation, but more common and sometimes more audible when compared with metal-on-polyethylene articulations. Zhao et al 49 performed a systematic review of 14 articles that evaluated occurrence of squeaking in fourth-generation CoC THAs. They arrived at an overall incidence of 3%, with remarkable variations depending on implant design.…”

Section: Articulating Materialsmentioning

confidence: 99%

Global diversity in bearings in primary THA

et al. 2020

View full text Add to dashboard Cite

Choice of articulating materials, head size and the design of the articulation will become decisive for the long-term performance of a total hip arthroplasty (THA) and especially in terms of risk for dislocation and wear-related problems. Here we account for common alternatives based on available studies and the evidence that can be derived from them. Metal or ceramic femoral heads articulating against a liner or cup made of highly cross-linked polyethylene and ceramic-on-ceramic articulations have about similar risk for complications leading to revision, whereas the performance of metal-on-metal articulations, especially with use of big heads, is inferior. The clinical significance of problems related to ceramic-on-ceramic articulations such as squeaking remains unclear. With use of current technology ceramic fractures are rare. Large femoral heads have the potential to increase the range of hip movement before impingement occurs and are therefore expected to reduce dislocation rates. On the other hand, issues related to bearing wear, corrosion at the taper-trunnion junction and groin pain may arise with larger heads and jeopardize the longevity of THA. Based on current knowledge, 32-mm heads seem to be optimal for metal-on-polyethylene bearings. Patients with ceramic-on-ceramic bearings may benefit from even larger heads such as 36 or 40 mm, but so far there are no long-term reports that confirm the safety of bearings larger than 36 mm. Assessment of lipped liners is difficult because randomized studies are lacking, but retrospective clinical studies and registry data seem to indicate that this liner modification will reduce the rate of dislocation or revision due to dislocation without clear evidence of clinically obvious problems due to neck-liner impingement. The majority of studies support the view that constrained liners and dual mobility cups (DMC) will reduce the risk of revision due to dislocation both in primary and revision THA, the latter gaining increasing popularity in some countries. Both these devices suffer from implant-specific problems, which seem to be more common for the constrained liner designs. The majority of studies of these implants suffer from various methodological problems, not least selection bias, which calls for randomized studies preferably in a multi-centre setting to obtain sufficient power. In the 2020s, the orthopaedic profession should place more effort on such studies, as has already been achieved within other medical specialties, to improve the level of evidence in the choice of articulation when performing one of the most common in-hospital surgical procedures in Europe. Cite this article: EFORT Open Rev 2020;5:763-775. DOI: 10.1302/2058-5241.5.200002

show abstract

“…Stanat and Capozzi24 conducted a meta-analysis on the third-generation CoC THAs and yielded a squeaking incidence of 2.4%. Zhao et al25…”

mentioning

confidence: 99%

The reasons for ceramic-on-ceramic revisions between the third- and fourth-generation bearings in total hip arthroplasty from multicentric registry data

Kim

Rhyu

Yoo

et al. 2021

Sci Rep

View full text Add to dashboard Cite

This study aimed to evaluate (1) the overall reasons for first revision in CoC THAs; (2) whether the reasons for revision differ between third-generation and fourth-generation CoC THAs; and (3) the specific factors associated with bearing-related problems as the reason for revision. We retrospectively reviewed 2045 patients (2194 hips) who underwent first revision THA between 2004 and 2013, among which 146 hips with CoC bearings underwent revision. There were 92 hips with third-generation ceramic bearings and 54 hips with fourth-generation ceramic bearings. The major reasons for CoC THA revisions were ceramic fracture and loosening of the cup or stem. When ceramic fracture, squeaking, incorrect ceramic insertion, and unexplained pain were defined as directly related or potentially related to ceramic use, 28.8% (42/146) of CoC revisions were associated with bearing-related problems. Among the third-generation ceramic bearings, revision was performed in 41.3% (38/92) of cases owing to bearing-related problems whereas revisions were performed for only 7.4% (4/54) of cases with fourth-generation ceramic bearings owing to bearing-related problems (p < 0.001). Younger age, lower American Society of Anesthesiologists (ASA) grade, and preoperative diagnosis of osteonecrosis were factors related to CoC THA revisions due to bearing-related problems.

show abstract

Squeaking in fourth-generation ceramic-on-ceramic total hip replacement and the relationship with prosthesis brands: meta-analysis and systematic review

Cited by 14 publications

References 49 publications

A Nomogram That Characterizes a Patient’s Odds of Developing Squeaking After Fourth-generation Ceramic-on-ceramic THA

A Nomogram That Characterizes a Patient’s Odds of Developing Squeaking After Fourth-generation Ceramic-on-ceramic THA

Global diversity in bearings in primary THA

The reasons for ceramic-on-ceramic revisions between the third- and fourth-generation bearings in total hip arthroplasty from multicentric registry data

Contact Info

Product

Resources

About