Are Noisy Ceramic-on-Ceramic Hips Linked to Periprosthetic Bone?
Explaining the genesis of squeaking in ceramic-on-ceramic (CoC) bearings used for total hip arthroplasty it has been postulated that audible noise requires amplification via the resonating stem. As in vivo stem resonance would be influenced by the periprosthetic bone this study compared stem fit&fill and periprosthetic bone between noisy and silent CoC hips. In a consecutive series of 186 primary CoC hips with identical stems, cups (Stryker ABG-II) and femoral heads (Alumina V40, 28 mm) a survey identified 38 noisy hips. Stem fit&fill and cortical wall thickness (CWT, medial and lateral) were measured on post-op AP x-rays. The endosteal width and lateral CWT was equal in noisy and silent hips However, medially, noisy hips had higher CWT at proximal and mid-stem level (p<0.05). Also fit&fill was higher and noisy stems were placed more proximal (p<0.05). Periprosthetic bone plays a role in the development of audible noise in CoC hips by providing particular conditions of support, damping and transmission for an oscillating stem which influences noise frequency and intensity.
Cortical wall thickness
Dual energy x-ray absorptiometry
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