Noise characteristics in ceramic-on-ceramic vs. metal-on-polyethylene total hip arthroplasty: a comparative study.
BACKGROUND
A comparison of noise in ceramic-on-ceramic (CoC) bearings and metal-on-polyethylene (MoP) bearings after total hip arthroplasty (THA) was undertaken. Noise associated with MoP implants is rarely reported and has not been linked to squeaking.


METHODS
A noise characterising hip questionnaire and Oxford Hip Score (OHS) was sent to 1,000 THA patients; there were 509 respondents 282 CoC and 227 MoP; mean age 63.7 years (range 45-92 years), mean follow up 33 months (range 6-156 months).


RESULTS
Of 282 repsondents 47 (17%) of the CoC patients reported noise compared to 19 (8%) of the MoP patients (p = 0.048); 9 CoC patients and 4 MoP patients reported squeaking. Overall, 27% patients with noise reported avoiding recreational activities because of it and patients with noisy hips scored on average 5 points less on the OHS (CoC: p = 0.04 and MoP: p = 0.007).


CONCLUSIONS
This is the first study to report squeaking from MoP THAs. The squeaking hip phenomenon is not exclusive to CoC THAs. Noisy hip implants may have social implications, and patients should be aware of this. We have shown a relationship between noise and a lower OHS. However, longer follow-up is needed to link noise to a poorly functioning implant.
 Royal Infirmary of Edinburgh, Edinburgh - UK.
Patrick G
PG
Robinson
 Orthopaedic Research Unit, Glasgow Royal Infirmary, Glasgow - UK.
Ian
I
Anthony
 Orthopaedic Research Unit, Glasgow Royal Infirmary, Glasgow - UK.
Sudeep
S
Kumar
 Orthopaedic Research Unit, Glasgow Royal Infirmary, Glasgow - UK.
Bryn
B
Jones
 Orthopaedic Research Unit, Glasgow Royal Infirmary, Glasgow - UK.
Andrew
A
Stark
 Orthopaedic Research Unit, Glasgow Royal Infirmary, Glasgow - UK.
Roland
R
Ingram
D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D002516:Ceramics; D006622:Hip Prosthesis; D006801:Humans; D008670:Metals; D008875:Middle Aged; D009622:Noise; D020959:Polyethylene; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors
D008670:Metals; D020959:Polyethylene