title: Incidental discovery of an undisplaced ceramic liner fracture at total hip arthroplasty revision for squeaking.
abstract: Squeaking has been reported after ceramic-on-ceramic total hip arthroplasty (THA), but its pathomechanics is not fully understood. Impaired lubrication is suspected to be the main reason. The management of patients impacted by this phenomenon is not well defined and, as it is not considered to be cause for alarm, revision is not strongly recommended. Here, we describe a ceramic insert fracture discovered during revision surgery performed to correct severe squeaking. Preoperative investigation (plain X-rays, ultrasound and computed tomography) did not reveal ceramic fracture or definite component malposition. To date, there are no other published cases of incidental discovery of a bearing component fracture during revision of ceramic-on-ceramic hip replacement due to squeaking. We believe that squeaking is not a trivial phenomenon and recommend careful management of patients suffering with this symptom.
authors.affiliation: Service d'orthopédie C, hôpital Roger-Salengro, centre hospitalier régional universitaire de Lille, 59037 Lille cedex, France. charles.dacheux@yahoo.fr
authors.forename: C
authors.initials: C
authors.lastname: Dacheux
authors.forename: D
authors.initials: D
authors.lastname: Bocquet
authors.forename: H
authors.initials: H
authors.lastname: Migaud
authors.forename: J
authors.initials: J
authors.lastname: Girard
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D002516:Ceramics; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D033162:Incidental Findings; D008297:Male; D009622:Noise; D015207:Osteoarthritis, Hip / Q000175:diagnosis / Q000601:surgery; D011474:Prosthesis Design; D011475:Prosthesis Failure; D020127:Recovery of Function; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D016896:Treatment Outcome
keywords: Ceramic failure; Squeaking; Total hip arthroplasty