High Incidence of Squeaking in THAs with Alumina Ceramic-on-ceramic Bearings

Ceramic-on-ceramic bearings in THA are a popular alternative to overcome wear concerns in traditional metal-polyethylene bearings. However, squeaking is a potentially worrisome phenomenon in ceramic-on-ceramic THAs which we observed in some of our patients. We reviewed all 42 patients who underwent...

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Bibliographic Details
Published in:Clinical orthopaedics and related research 2008-06, Vol.466 (6), p.1438-1443
Main Authors: Keurentjes, J. C., Kuipers, R. M., Wever, D. J., Schreurs, B. W.
Format: Article
Language:English
Subjects:
Adult
Aged
Aluminum Oxide
Arthroplasty, Replacement, Hip - instrumentation
Biological and medical sciences
Cohort Studies
Conservative Orthopedics
Diseases of the osteoarticular system
Female
Hip Prosthesis - adverse effects
Humans
Incidence
Joint Diseases - etiology
Joint Diseases - physiopathology
Joint Diseases - surgery
Male
Medical sciences
Medicine
Medicine & Public Health
Middle Aged
Original
Original Article
Orthopedic surgery
Orthopedics
Prosthesis Design
Prosthesis Failure
Range of Motion, Articular
Retrospective Studies
Sound
Sports Medicine
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgical Orthopedics
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Summary:Ceramic-on-ceramic bearings in THA are a popular alternative to overcome wear concerns in traditional metal-polyethylene bearings. However, squeaking is a potentially worrisome phenomenon in ceramic-on-ceramic THAs which we observed in some of our patients. We reviewed all 42 patients who underwent 43 ceramic-on-ceramic noncemented THAs during the time of the study. Squeaking, defined as a reproducible sound of squeaking, clicking, or grating, occurred in nine of 43 implants (20.9%). Standard radiographs were normal. We used CT imaging to determine cup anteversion and inclination angles, comparing the squeaking hips with those of a randomly selected control group, but found no differences. We then hypothesized specific design features (stem size, cup size, head size, and neck length of the head) would be risk factors for squeaking. We found a difference in neck length between squeaking and nonsqueaking implants. A neck length of −4 mm or shorter resulted in a relative risk of 5.56 (95% confidence interval, 1.14–27.01) for squeaking. We found a high incidence of squeaking in our population, and we believe this phenomenon is an underreported side effect of these types of bearings. A short neck length of the femoral implant was a risk factor for squeaking in ceramic-on-ceramic THA. Level of Evidence: Level III, therapeutic study.
ISSN:0009-921X
1528-1132
DOI:10.1007/s11999-008-0177-8