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Report finds 17% of ceramic implants studied squeaked, clicked or grated

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NICE — A study presented here revealed that audible noise in ceramic-on-ceramic bearing surfaces in total hip arthroplasty continues to pose a problem for some patients.

Still, the researchers could not verify a link between cup positioning and noise from the operated hip, according to the report.

Clinical investigators from Vejle Hospital in Denmark used a local total hip arthroplasty (THA) database to study 107 patients who received 126 ceramic-on-ceramic hips. They interviewed all 107 patients by telephone using a standardized questionnaire.

"We asked them if they heard any noise from their operated hip, and if they confirmed that, we asked them what kind of noise they heard," said Claus Varnum, MD, who presented the findings at the 9th European Federation of National Associations of Orthopaedics and Traumatology Congress, here. "This is the first study that we are aware of that tracked the different kinds of sounds coming out of the hips."

Thirteen hips (10.3%) produced a noise at the time of the interview (Group A). Nine hips (7.2%) had a noise that disappeared on its own (Group B), and 104 hips (82.5%) were never noisy (Group C).

In Group A, seven hips (53.8%) were clicking at the time of the interview, three hips (23.1%) both clicked and squeaked, and three hips (23.1%) were grating. In Group B, four hips (44.4%) had clicked previously, three hips (33.3%) had squeaked and two hips (22.2%) made grating sounds.

The researchers also examined the X-rays of all 126 hips and determined the inclination and anteversion of the cups.

The "safe zone" was defined as 25°±10° anteversion and 45°±10° inclination, he said.

According to Varnum, 69.2% of the hips in group A and 44.4% and 59.6% in Groups B and C, respectively, were in the safe zone.

"There were no significant differences in cup anteversion and inclination between Group A and Groups B and C," he added.

For more information:

• Varnum C, Vester T, Revald P, Kjaersgaard-Andersen P. Ceramic bearings in total hip arthroplasty: frequency and type of noises. Paper F12. Presented at the 9th European Federation of National Associations of Orthopaedics and Traumatology Congress. May 29-June 1, 2008. Nice.