Investigators find no link between hip component position, squeaking

Schroder S. Clin Orthop Relat Res. doi:10.1007/s11999-010-1574-3.

A study of patients who underwent total hip arthroplasty showed that a small percentage of patients reported squeaking related to their ceramic-on-ceramic total hip bearings, but none of them required revision for this issue.

David Schroder, MD, and colleagues at the Hospital for Special Surgery, in New York City, prospectively entered information regarding 436 alumina-on-alumina, cementless primary total hip arthroplasties (THAs) performed in 364 patients into their institutional database. All patients received the same surgical technique and implant. The investigators collected Harris Hip scores and responses to a noise questionnaire. In addition, they evaluated radiographic component position and loosening. They measured and compared the difference in abduction angle in patients who had squeaking components and those who did not. The patients were followed for a minimum of 2 years.

Preoperatively, the mean Harris Hip score was 51.9; it increased to 94.4 at the latest follow-up. Four hips (1.1%) were re-operated for dislocation, and two (0.53%) were reoperated for periprosthetic fracture after trauma. The noise rate of any type was 11%; the most common noise type was clicking and snapping. Overall, 1.9% of patients reported squeaking; none were revised for this issue.

“At average 3-years follow-up, 98% of ceramic-on-ceramic THAs did not require a revision, with 1.1% of hips having been revised for dislocation,” the authors wrote in their study. “Fewer than 2% of patients reported hearing an audible squeak, with no association found between component position and squeaking.”