Clinical Orthopaedics and Related Research®

, Volume 469, Issue 2, pp 437–442

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

  • David Schroder
  • Lindsey Bornstein
  • Mathias P. G. Bostrom
  • Bryan J. Nestor
  • Douglas E. Padgett
  • Geoffrey H. Westrich
Symposium: Papers Presented at the Hip Society Meetings 2010

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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Copyright information

© The Association of Bone and Joint Surgeons® 2010

Authors and Affiliations

  • David Schroder
    • 1
  • Lindsey Bornstein
    • 1
  • Mathias P. G. Bostrom
    • 2
  • Bryan J. Nestor
    • 2
  • Douglas E. Padgett
    • 2
  • Geoffrey H. Westrich
    • 2
  1. 1.Department of Orthopaedic SurgeryHospital for Special SurgeryNew YorkUSA
  2. 2.Department of Orthopaedic SurgeryHospital for Special Surgery, Weill Cornell Medical CollegeNew YorkUSA

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