title: Influence of prosthetic design on squeaking after ceramic-on-ceramic total hip arthroplasty.
abstract: Squeaky ceramic-on-ceramic (COC) total hips have received much recent publicity, and implant design may be implicated. We reviewed 270 consecutive COC total hip arthroplasties in 233 patients comparing 4 implant combinations representing 4 manufacturers. A cohort (n = 45) of Stryker Trident acetabular cups paired with Stryker Accolade femoral stems showed a dramatically higher incidence of "problem squeaking"--defined as always audible to others and occurring at least once per week--with a 35.6% incidence of squeaking and 11.1% incidence of problem squeaking. The 3 non-Stryker designs (n = 225) revealed 3.6% squeaking (P < .0001) and 0.44% problem squeaking (P = .006). The Stryker system has a unique design and metallurgy. Our results suggest that although the genesis of squeaking in COC total hips is multifactorial, prosthetic design plays a key role.
authors.affiliation: Swanson Hip and Knee Center of Excellence and Research Institute at Desert Orthopaedic Center Las Vegas, NV 89121, USA.
authors.forename: Todd V
authors.initials: TV
authors.lastname: Swanson
authors.forename: David J
authors.initials: DJ
authors.lastname: Peterson
authors.forename: Raghavendran
authors.initials: R
authors.lastname: Seethala
authors.forename: Ryan L
authors.initials: RL
authors.lastname: Bliss
authors.forename: Calvin A
authors.initials: CA
authors.lastname: Spellmon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000601:surgery; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D002516:Ceramics; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009622:Noise; D015207:Osteoarthritis, Hip / Q000601:surgery; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012189:Retrospective Studies; D055815:Young Adult