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.
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patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved or waived approval for the human protocol for this investigation
and that all investigations were conducted in conformity with ethical principles of research.