title: High prevalence of noise following Delta ceramic-on-ceramic total hip arthroplasty.
abstract: OBJECTIVE
  We evaluated the short-term functional outcome and prevalence of bearing-specific generation of audible noise in 301 patients (336 hips) operated on with fourth generation (Delta) medium diameter head, ceramic-on-ceramic (CoC) total hip arthroplasties (THAs).
  
  
  METHODS
  There were 191 female (63%) and 110 male patients (37%) with a mean age of 61 years (29 to 78) and mean follow-up of 2.1 years (1.3 to 3.4). Patients completed three questionnaires: Oxford Hip Score (OHS), Research and Development 36-item health survey (RAND-36) and a noise-specific symptom questionnaire. Plain radiographs were also analysed. A total of three hips (0.9%) were revised.
  
  
  RESULTS
  There were 52 patients (54 hips, 17%) who reported noise, and in 25 (48%) of them the noise was frequently heard. In the multiple regression analysis, the only independent risk factor for noise was a specific THA brand, with a threefold increased risk (95% confidence intervals 1.39 to 6.45, p = 0.005) of noise compared with the reference THA brand. Patients with noisy hips had lower median OHS (43 versus 46.5, p = 0.002) and their physical functioning (p = 0.021) subscale in RAND-36 was reduced.
  
  
  CONCLUSIONS
  Noise was surprisingly common in this population. Cite this article: Bone Joint J 2017;99-B:44-50.
authors.affiliation: Tampere University Hospital, School of Medicine, 33014 Tampere, Finland.
authors.forename: P P
authors.initials: PP
authors.lastname: Salo
authors.affiliation: Coxa Hospital for Joint Replacement, PL 652, 33101 Tampere, Finland.
authors.forename: P B
authors.initials: PB
authors.lastname: Honkanen
authors.affiliation: Coxa Hospital for Joint Replacement, PL 652, 33101 Tampere, Finland.
authors.forename: I
authors.initials: I
authors.lastname: Ivanova
authors.affiliation: Coxa Hospital for Joint Replacement, PL 652, 33101 Tampere, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Reito
authors.affiliation: Coxa Hospital for Joint Replacement, PL 652, 33101 Tampere, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Pajamäki
authors.affiliation: Coxa Hospital for Joint Replacement, PL 652, 33101 Tampere, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Eskelinen
mesh_terms: D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000295:instrumentation; D002516:Ceramics; D005260:Female; D005500:Follow-Up Studies; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009622:Noise; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery; D057068:Periprosthetic Fractures / Q000209:etiology / Q000601:surgery; D011474:Prosthesis Design; D011475:Prosthesis Failure / Q000009:adverse effects; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000601:surgery; D012086:Reoperation
keywords: Ceramic-on-ceramic; Delta; Noise; Squeaking; Total hip arthroplasty