The Squeaking Hip: A Phenomenon of Ceramic-on-Ceramic Total Hip Arthroplasty

128

The incidence of hip ''squeak'' associated with ceramic-on-ceramic bearings has been variably reported, ranging from 0.7% to 20.9%. We determined the patients' perception of squeaking in 306 patients (336 hips) in whom ceramic-on-ceramic total hip arthroplasties (THAs) were performed between 1997 and 2005. A questionnaire regarding hip noise was obtained by telephone. With a minimum followup of 2 years (mean, 3.9 years; range, 2-10 years), 290 patients (320 or 95% of the THAs) completed the questionnaire. Patients reported hip noise in 55 of the 320 THAs (17%); noise was perceived as squeak in 32 of the 320 (10%). Most squeaking hips (29 of 32) were pain-free and symptom-free. One patient was unhappy with his squeaking hip without pain. Our data suggest a much higher incidence of squeak as perceived by patients than previously reported.

Section: Discussionsupporting

confidence: 94%

Incidence of ‘Squeaking’ After Ceramic-on-Ceramic Total Hip Arthroplasty

Mai¹,

Verioti

Ezzet

et al. 2010

128

“…The prevalence of squeaking probably is underreported because the noise often is transient and patients are not specifically interviewed regarding this complication during followup consultations. Higher proportions of squeaking hips might be observed if patient-based questionnaires would be used [22]. The exact mechanism for squeaking remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Ceramic-on-ceramic THA Implants in Patients Younger Than 20 Years

Hannouche

Devriese

Delambre

et al. 2016

“…We evaluated questionnaires on the history of ceramic fracture, dislocation, reoperation, and the noise around the hip, which was classified into squeaking, clicking, grinding, and popping [17] at each followup and snapping was excluded through physical examination or ultrasonography. These complications were investigated by routine radiographs as well.…”

Section: Methodsmentioning

confidence: 99%

Do Alumina Matrix Composite Bearings Decrease Hip Noises and Bearing Fractures at a Minimum of 5 Years After THA?

Baek

Kim

et al. 2015

Background Ceramic-on-ceramic bearing couples are theoretically attractive in total hip arthroplasty (THA) because of low wear, but concerns regarding ceramic fracture and squeaking have arisen. Improved material properties of newer alumina matrix composite (AMC) materials, known as Delta ceramics, may reduce these risks. In addition, the use of thinner liners and larger femoral heads may be helpful clinically to lower the rate of dislocation. However, limited short-term clinical results are available and intermediate-term effects are unclear. Questions/purposes (1) What is the frequency of bearingrelated complications (dissociation, fracture, and noise) with ceramic-on-ceramic AMC bearings in cementless THA? (2) What other complications arose in patients treated with these bearings? (3) What are the Harris hip scores (HHS) and survivorship free from reoperation and revision at a minimum of 5 years after cementless THA performed with AMC bearings? Methods Over a 9-month period in 2009, one surgeon performed 125 THAs, of which 100 (80% of the total) were performed with cementless, AMC bearings. During the period in question, the exclusion criteria for this implant were primary THAs with severe acetabular or femoral bone defect and revision THAs. Of these, 94 hips (95%) in 91 patients were available for analysis at a minimum of 5 years (range, 5-6 years), because five patients (six hips) had died. Mean age at the time of arthroplasty was 55 ± 14 years. Prostheses with an identical design and Biolox 1 Delta ceramics were used in all patients. Noise was classified into squeaking, clicking, grinding, and popping. Ceramic fracture, dislocation, and any other complications associated with the use of AMC ceramics were also investigated. Clinical evaluation included the modified HHS preoperatively and at each followup. Survivorship free from reoperation and revision was calculated using the Kaplan-Meier method. Results Of 91 patients, four developed bearing-related complications, including one with liner dissociation despite initial square seating and three with clicking. No patients had ceramic fractures. A single event of perioperative dislocation occurred in one patient and postoperative periprosthetic fracture occurred in two hips. Mean HHS improved from 56 to 93 points at the final followup (p \ 0.001). Survivorship at 5 years free from reoperation and revision was 96.8% and 97.9%, respectively.