title: Ceramic-on-ceramic total hip arthroplasty: is squeaking related to an inaccurate three-dimensional hip anatomy reconstruction?
abstract: Many factors were incriminated in the squeaking generation in ceramic-on-ceramic total hip arthroplasty (THA), including the cup positioning and design. However, the influence of the stem orientation has not been investigated and the true three-dimensional hip anatomy has never been compared to the contralateral healthy hip. Three patients, who underwent unilateral ceramic-on-ceramic THA, complained of squeaking. CT-scans were performed to compare the true three-dimensional hip anatomy to the contralateral healthy hip. All patients presented evidence of posterior neck-rim impingement with a two-fold increase in the global anteversion (above 75°) comparatively to the healthy hip. The excess of anteversion was on the cup side in 2 cases and on the stem side in 1 case. We conclude that squeaking in ceramic-on-ceramic THA could be related to a poor accuracy of 3D hip anatomy reconstruction which generated a posterior impingement and subsequent anterior edge loading because of excessive global anteversion.
authors.affiliation: Service d'orthopédie traumatologique, hôpital Pitié-Salpétrière, 83, boulevard de l'Hôpital, 75013 Paris, France. Electronic address: hedisari@yahoo.fr.
authors.forename: E
authors.initials: E
authors.lastname: Sariali
authors.affiliation: Service d'orthopédie traumatologique, hôpital Pitié-Salpétrière, 83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Klouche
authors.affiliation: Hôpital la Croix Saint-Simon, 125, rue d'Avron, 75020 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Mamoudy
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D002516:Ceramics; D005260:Female; D006621:Hip Joint / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009622:Noise; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery*; D011475:Prosthesis Failure; D014057:Tomography, X-Ray Computed
keywords: Anatomy; Ceramic; Hip arthroplasty; Squeaking hip; Three-dimensional