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Ceramic-on-Ceramic Total Hip Arthroplasty: Incidence of Instability and Noise

  • Symposium: Papers Presented at the Hip Society Meetings 2010
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Alternative bearing materials in THA have been developed to reduce the incidence of osteolysis. Alumina-on-alumina bearings exhibit extremely low wear rates in vitro, but concerns exist regarding component impingement with the potential for dislocation and the occurrence of noise.

Questions/purposes

We determined generation of squeaking and the relationship between squeaking and component position.

Methods

We prospectively entered 436 alumina-on-alumina, cementless, primary THAs in 364 patients into our institutional database. All procedures were performed with the same surgical technique and the same implant. We obtained Harris Hip scores and a noise questionnaire and assessed radiographic component position and loosening. We determined the difference in abduction angle between squeakers and nonsqueakers. Minimum followup was 2 years (average, 3.5 years; range, 2.0–6.2 years).

Results

The mean Harris hip score increased from 51.9 preoperatively to 94.4 at latest followup. Six hips underwent reoperation: four hips (1.1%) for dislocation and two (0.53%) for periprosthetic fracture after trauma. The incidence of noise of any type was 11%, with the most common type of noise being clicking or snapping. Squeaking was reported by 1.9% of patients, with no patient being revised for this phenomenon. We found no association between component position and squeaking.

Conclusions

At average 3 years followup, 98% of ceramic-on-ceramic THAs did not require a revision, with 1.1% of hips having been revised for dislocation. Fewer than 2% of patients reported hearing an audible squeak, with no association found between component position and squeaking.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgment

We thank Kristin Foote for her assistance with data collection for this study.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA

    David Schroder MD & Lindsey Bornstein BA

  2. Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA

    Mathias P. G. Bostrom MD, Bryan J. Nestor MD, Douglas E. Padgett MD & Geoffrey H. Westrich MD

Authors
  1. David Schroder MD
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  2. Lindsey Bornstein BA
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  3. Mathias P. G. Bostrom MD
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  4. Bryan J. Nestor MD
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  5. Douglas E. Padgett MD
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  6. Geoffrey H. Westrich MD
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Corresponding author

Correspondence to Geoffrey H. Westrich MD.

Additional information

One of the authors (GW) has received funding from Stryker Orthopaedics for a partial research assistant for this study and is a consultant for Stryker Orthopaedics (Mahwah, NJ).

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

Appendix 1: Total Hip Replacement Questionnaire

Appendix 1: Total Hip Replacement Questionnaire

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Schroder, D., Bornstein, L., Bostrom, M.P.G. et al. Ceramic-on-Ceramic Total Hip Arthroplasty: Incidence of Instability and Noise. Clin Orthop Relat Res 469, 437–442 (2011). https://doi.org/10.1007/s11999-010-1574-3

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  • DOI: https://doi.org/10.1007/s11999-010-1574-3

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