Incidence of ‘Squeaking’ After Ceramic-on-Ceramic Total Hip Arthroplasty

Mai, Kenny; Verioti, Christopher A; Ezzet, Kace A.; Copp, Steven N.; Walker, Richard; Colwell, Clifford W.

doi:10.1007/s11999-009-1083-4

Cited by 125 publications

(86 citation statements)

References 15 publications

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“…This may be disadvantageous especially with hard-on-hard articulations, as the impact can cause local damage of the contacting surfaces. A click and a squeak are sounds produced by some hardon-hard articulations [10][11][12]. The click is likely to result from the impact of the separated bearing surfaces after the heel strike.…”

Section: Introductionmentioning

confidence: 99%

Adverse condition testing with hip simulators

Saikko

2015

Biotribology

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Recent clinical failures and abnormal sounds observed in certain prosthetic hip designs have directed attention to adverse condition hip simulator testing. In the present study, hip simulator wear and friction tests were made with a macroscopic separation of the bearing surfaces in the swing phase, steep acetabular cup position, increased load, poor or lacking lubrication, roughened bearing surfaces including titanium third bodies, and with combinations of these. The only conditions that resulted in squeaking were dry sliding with alumina-on-alumina and metal-on-metal, and an extreme peak load of 4 kN with serum lubricated metal-on-metal. The wear rate of metal-on-metal increased by an order of magnitude when the cup position was steep, 64 degrees, compared with the optimal position of 48 degrees. The increase of the peak load from 2 kN to 3 kN with the cup position of 48 degrees increased the running-in wear of metal-on-metal, but the steady state wear rates were equally low, of the order of 1 mg per one million cycles. Crosslinked polyethylene was the superior cup material under adverse conditions, including dry sliding and roughened femoral head.

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Section: Introductionmentioning

confidence: 99%

Adverse condition testing with hip simulators

Saikko

2015

Biotribology

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“…Ceramic-on-ceramic combinations have been found to squeak and break [25,39] and require optimal placement to avoid the risk of neck-to-socket impingement [41,43]. Metal-on-metal combinations have been associated with pseudotumor formation [2,21] and increased metal ion release, which may lead to cell apoptosis and to DNA changes [22].…”

Section: Introductionmentioning

confidence: 99%

Oxidized Zirconium Head on Crosslinked Polyethylene Liner in Total Hip Arthroplasty: A 7- to 12-year In Vivo Comparative Wear Study

Karidakis

Karachalios

2015

Clinical Orthopaedics &Amp; Related Research

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Background Osteolysis resulting from wear debris production from the bearing surfaces is a major factor limiting long-term survival of hip implants. Oxidized zirconium head on crosslinked polyethylene (XLPE) is a modern bearing coupling. However, midterm in vivo wear data of this coupling are not known. Questions/purposes The purpose of this study was to investigate in vivo whether the combination of an oxidized zirconium femoral head on XLPE produces less wear than a ceramic head on XLPE or a ceramic head on conventional polyethylene (CPE) couplings and whether any of these bearing combinations results in higher hip scores. Methods Between 2003 and 2007, we performed 356 total hip arthroplasties in 288 patients; of those, 199 (69.1%) patients (199 hips) were enrolled in what began as a randomized trial. Unfortunately, after the 57 th patient, the randomization process was halted because of patients' preference for the oxidized zirconium bearing instead of the ceramic after (as they were informed by the consent form), and after that, alternate allocation to the study groups was performed. Hips were allocated into four groups: in Group A, a 28-mm ceramic head on CPE was used; in Group B, a 28-mm ceramic head on XLPE; in Group C, a 28-mm Oxinium head on XLPE; and in Group D, a 32-mm Oxinium head on XLPE. The authors prospectively collected in vivo wear data (linear wear, linear wear rate, volumetric wear, and volumetric wear rate) using PolyWare software. Preoperative and postoperative clinical data, including Harris and Oxford hip scores, were also collected at regular intervals. Of those patients enrolled, 188 (95%) were available for final followup at a minimum of 7 years (mean, 9 years; range, 7-12 years). Results All bearing surfaces showed a varying high bedding-in effect (plastic deformation of the liner) up to the second postoperative year. At 5 years both oxidized zirconium on XLPE groups showed lower (p \ 0.01) volumetric wear (mean ± SD mm 3 ) and volumetric wear rates (mean ± SD mm 3 /year) ( Res (2015) 473:3836-3845 DOI 10.1007 Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons® (Group C: 356 ± 64 to 215 ± 54 mm 3 /year, Group D: 354 ± 50 to 210 ± 64 mm 3 /year) when compared with ceramic on CPE (Group A: 895 ± 131 to 380 ± 80 mm 3 /year) and ceramic on XLPE (Group B: 1625 ± 253 to 480 ± 101 mm 3 /year) groups. When wear rates of both oxidized zirconium groups were compared, no differences were found at any time interval with the numbers available. Two hips (one from Group A and one from Group B) are scheduled for revision as a result of wear and osteolysis. There were no differences in hip scores among the groups with the numbers available. Conclusions In this study, in vivo wear parameters were lower when the combination of an oxidized zirconium head on XLPE liner was used at an average of 9 years (range, 7-12 years) followup. Further larger-scale clinical studies should confirm these findings and evaluate osteolysis and revision rates...

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“…Stanat and Capozzi [30], in a metaanalysis of 12 studies assessing outcomes after CoC THA, noted the frequency of squeaking to be 2.4%. However, studies assessing noise generation as a whole (inclusive of squeaking) have reported much higher frequency rates [23,24]. In a prospective evaluation of 208 CoC THAs, McDonnell et al [24] noted 11% to report noises other than squeaking, 8% irreproducible squeaking, and 13% reproducible squeaking.…”

Section: Discussionmentioning

confidence: 99%

“…The cause of noise generation in hardon-hard bearings is an area of much debate, because some studies have pointed toward component design [30,31], others have reported decreased acetabular inclination and anteversion to be risk factors in CoC implants [24], whereas increased acetabular inclination has been noted as a risk factor in MoM implants [4]. Additional potential causes include loss of bearing surface lubrication [7,32] and femoral component neck geometry [23]. Our study suggests that noise generation is associated with residual symptoms after THA.…”

Section: Discussionmentioning

confidence: 99%

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Hard-on-Hard Bearings Are Associated With Increased Noise Generation in Young Patients Undergoing Hip Arthroplasty

Nam

Barrack

Johnson

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Patient-perceived noise from prostheses after total hip arthroplasty (THA) does occur, yet questions remain including the overall frequency of this finding, demographic and prosthesis-related factors, and the association of noise generation with patient-reported outcomes. Questions/purposes The purposes of this study were (1) to determine the frequency with which patients report noise coming from the hip after THA; (2) to identify patient and prosthesis-related factors associated with noise generation; and (3) to ascertain if noise generation is associated with pain or functional impairment after THA. Methods A five-center study was designed to quantify the degree of residual symptoms and functional deficits in patients undergoing THA. Three centers were academic practices, whereas two centers were private practices that provided training programs for orthopaedic residents and fellows. Each contributing surgeon was fellowship-trained and specialized in joint replacement. Inclusion criteria for this study were (1) men between 18 and 60 years old and women between 18 and 55 years old; (2) patients requiring primary hip surgery as a result of noninflammatory arthritis such as osteoarthritis, traumatic arthritis, or avascular necrosis; (3) a UCLA activity score of 6 or more before they were limited by pain; and (4) patients who had undergone a primary THA within 1 to 4 years before the start of the study and had a minimum of 1 year of clinical followup. Attempts were made to contact all identified patients meeting these inclusion criteria. Data were collected by an independent, third-party survey center blinded to the implant design and bearing surface used who administered questionnaires about residual symptoms, function, and pre-and postoperative activity levels using previously published survey instruments. Patients were specifically queried regarding perceived noise from their THA. We retrospectively identified 1242 eligible patients. Of the 1242 patients, 105 were found to have exclusions during the screening section of the questionnaire: postoperative infection (six THAs), fracture (two), dislocation (seven), or revision (17); limited activity level because of an operation on the opposite hip (34); and premorbid UCLA score of less than 6 (39). In addition, 128 individuals refused to participate, 156 were never available, 108 were not found as a result of a bad address/phone number, 48 were contacted but did not complete the interview, nine 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. had died, and six had a language barrier. This left 682 of the 1137 eligible patients with completed surveys (60% response rate). The mean age was 50 ± 8 years at the time of surgery with 63% being men, and they were contacted at a mean of 3 ± 1 years postoperatively. Bearing surfaces (femoral head...

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Incidence of ‘Squeaking’ After Ceramic-on-Ceramic Total Hip Arthroplasty

Cited by 125 publications

References 15 publications

Adverse condition testing with hip simulators

Adverse condition testing with hip simulators

Oxidized Zirconium Head on Crosslinked Polyethylene Liner in Total Hip Arthroplasty: A 7- to 12-year In Vivo Comparative Wear Study

Hard-on-Hard Bearings Are Associated With Increased Noise Generation in Young Patients Undergoing Hip Arthroplasty

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