Natural history of squeaking after total hip arthroplasty.
BACKGROUND
In recent years, a number of alternative bearing surfaces, such as ceramic on ceramic, are being used in THA. Squeaking after THA is a recently recognized complication; however, its incidence is unknown.


OBJECTIVE
Find the incidence of squeaking; when it ensues; activities associated to squeaking; its natural history, and outcome of revisions for squeaking.


METHODS
A prospective observational study between 2002 and 2007; yield 1486 ceramic-on-ceramic THA performed at our institution. All patients were followed up by office visits or by phone, to obtain information regarding squeaking, pain and function. Minimum followup was 2.5 years (mean, 5.5 years; range, 2.5-7.9 years).


RESULTS
Ninety-five of the 1486 hips (6%) developed squeaking after THA, 39 females (44%) and 49 males (56%) with an average age of 49.9 years. Squeaking began on average 19.7 months after surgery but not associated with pain or functional impairment in any patient. Squeaking could be heard during walking (38%), ascending stairs (24%), bending forward (21%), and other activities (18%), was constant in 26% of the patients and intermittent in 74%. The intensity and frequency remained similar over time in 70% of the patients.


CONCLUSIONS
Squeaking is a real phenomenon that occurred in about 6% of our patients. The etiology for this problem remains elusive and is likely to be multifactorial in nature. Squeaking, when developed, does not seem to be self-limited and persists in the majority. Nine patients underwent revision arthroplasty for squeaking. No fractures or other implant-related issues were observed.


METHODS
Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
Restrepo
Camilo
C
The Rothman Institute of Orthopaedics at Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107, USA.
Matar
Wadih Y
WY
Parvizi
Javad
J
Rothman
Richard H
RH
Hozack
William J
WJ
D000203:Activities of Daily Living; D000293:Adolescent; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation*; D002516:Ceramics; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009622:Noise; D011446:Prospective Studies; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult