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Incidence and Factors Associated with Squeaking in Alumina-on-Alumina THA

  • Symposium: Papers Presented at the 2009 Closed Meeting of the International Hip Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

The alumina-on-alumina bearing surface, which has a high wear resistance and a good biocompatibility, is widely used in THA but recently has been associated with squeaking. While various authors have reported factors associated with squeaking, they remain poorly understood.

Questions/purposes

To contribute to the debate on squeaking we therefore asked the following questions: (1) What is the incidence of squeaking in alumina-on-alumina THA? (2) What factors are associated with squeaking in alumina bearings in our practice?

Methods

We retrospectively reviewed 168 patients (173 hips) who had primary alumina-on-alumina THAs. The mean age of the patients was 53 years (range, 18 to 81 years). Minimum followup was 5.6 years (average, 7.3 years; range, 5.6–9.4 years). All patients were evaluated clinically and radiographically with attention to periprosthetic osteolysis, squeaking, and ceramic fracture. When the patient reported squeaking, we determined the onset, reproducibility, and activities associated with the squeaking. We recorded patient (gender, age, height, weight, and body mass index) and surgical factors (abduction angle of cup, size and length of ceramic head component, and diameter of cup in the implant).

Results

Eight of the 168 patients (5%) had squeaking hips. Squeaking was more common in males and in those with large ceramic heads. There were no complications or revisions in the squeaking group. One ceramic liner fracture was associated with trochanteric nonunion.

Conclusions

When recommending alumina-on-alumina bearing surfaces to patients they should be clearly informed of the possibility of squeaking. Patients with risk factors for squeaking should be followed at regular intervals.

Level of Evidence

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

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Acknowledgments

We thank Professor Adam Turner, Hanyang University, for his help in revising our manuscript.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hanyang University Seoul Hospital, Seoul, South Korea

    Il-Yong Choi MD, Yee-Suk Kim MD & Kyu-Tae Hwang MD

  2. Department of Orthopaedic Surgery, Hanyang University Guri Hospital, 249-1 Gyomun-dong, Guri-si, Gyunggi-do, 471-701, South Korea

    Young-Ho Kim MD

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  1. Il-Yong Choi MD
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  2. Yee-Suk Kim MD
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Correspondence to Young-Ho Kim MD.

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Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, 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 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.

This work was performed at Hanyang University Hospital, Seoul, South Korea.

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Choi, IY., Kim, YS., Hwang, KT. et al. Incidence and Factors Associated with Squeaking in Alumina-on-Alumina THA. Clin Orthop Relat Res 468, 3234–3239 (2010). https://doi.org/10.1007/s11999-010-1394-5

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