Squeaking is a well-recognized complication for hardon-hard bearings.The nature of squeaking is not yet completely understood however it is considered a multifactorial phenomenon.Patient,implant,and surgical factors p...Squeaking is a well-recognized complication for hardon-hard bearings.The nature of squeaking is not yet completely understood however it is considered a multifactorial phenomenon.Patient,implant,and surgical factors play a role in squeaking.It is believed that mechanisms damaging the fluid film lubrication in which these bearings function optimally have a critical role.Such mechanisms include edge loading,stripe wear,impingement,third body particles and ceramic fracture.The resonance of metallic parts can produce noise in the human audible range hence the implant metallurgic composition and design may play a role.Implant positioning can facilitate impingement and edge loading enhancing the occurrence of squeaking.The recent introduction of large heads(> 36 mm) 4th generation ceramic-on-ceramic bearing may accentuate the conditions facilitating noise formation; however the current literature is insufficient.Clinically,squeaking may manifest in extreme hip positions or during normal gait cycle however it is rarely associated with pain.Evaluations of patients with squeaking include clinical and radiographic assessments.Computer tomography is recommended as it can better reveal ceramic breakage and implant malposition.The treatments for most squeaking patients include reassurance and activity modification.However for some,noise can be a problem,requiring further surgical intervention.In the occurrence of ceramic fracture,implant failure,extreme components malposition,instability and impingement,surgery should be advised.This review will aim to discuss the current literature regarding squeaking.展开更多
Objective： The present study aimed to review the characteristics and influencing factors of squeaking after ceramic-on-ceramic （CoC） total hip arthroplasty （THA） and to analyze the possible mechanisms of the audi...Objective： The present study aimed to review the characteristics and influencing factors of squeaking after ceramic-on-ceramic （CoC） total hip arthroplasty （THA） and to analyze the possible mechanisms of the audible noise. Data Sources： The data analyzed in this review were based on articles from PubMed and Web of Science. Study Selection： The articles selected for review were original articles and reviews found based on the following search terms： “total hip arthroplasty”, “ceramic-on-ceramic”, “hip squeaking”, and “hip noise.” Results： The mechanism of the squeaking remains unknown. The possible explanations included stripe wear, edge loading, a third body, fracture of the ceramic liner, and resonance of the prosthesis components. Squeaking occurrence is influenced by patient, surgical, and implant factors. Conclusions： Most studies indicated that squeaking after CoC THA was the consequence of increasing wear or impingement, caused by prosthesis design, patient characteristics, or surgical factors. However, as conflicts exist among different articles, the major reasons for the squeaking rernain to be identified.展开更多
Background: Asian cultures require floor-seated positions demanding a high range of motion (ROM). Ceramic-On-Ceramic (COC) interface allowed the use of larger head with reduced wear debris generation and adverse tissu...Background: Asian cultures require floor-seated positions demanding a high range of motion (ROM). Ceramic-On-Ceramic (COC) interface allowed the use of larger head with reduced wear debris generation and adverse tissue reactions. This study was conducted to analyze 6-year clinical-radiological outcome with large head fourth generation DeltaMotion®ceramic-on-ceramic (COC) hip articulation, with special emphasis on postoperative ROM, ability to sit cross-legged, stability, hip noise and revision surgery. Material and Methods: 150 consecutive hips were operated for primary cementless Total Hip Replacement (THR) using DeltaMotion®at a tertiary care center in Mumbai, India, between January 2010 and January 2015. Clinico-radiological outcome was assessed using the Harris Hip Score (HHS) and radiographs at 6 weeks, 6 months, and annually thereafter. Results: 108 (74.5%) patients were males and 37 (25.5%) were females with an average age of 50.87 years. Mean follow-up was 54 months (range: 37 - 86 months). The mean ROM was 120° in flexion, 10° in extension, 30° in adduction, 45° in abduction, 25° in internal rotation and 25° in external rotation. The mean HHS showed a statistically significant improvement of 64.5% (from 54.66 ± 6.42 pre-operatively to 89.95 ± 4.32 post operatively) (p-value: 0.001). 92% of patients were able to sit in squatting position and 92% were able to sit cross-legged on the floor at last follow-up. 0.7% joints (1 hip) had squeaking. Considering no revision surgery as the end point, 6-year prosthesis survivorship was 100%. Complications (superficial infection) occurred in three hips (2%). All patients reported to be satisfied with their outcome after surgery. Conclusion: We infer that DeltaMotion large head COC bearing allows scope for using larger head size in relatively smaller Indian hips due to factory fitted ceramic lining. At 6-year follow-up, high activity level was observed with excellent clinical-radiological outcomes and component longevity in relatively young Indian population.展开更多
文摘Squeaking is a well-recognized complication for hardon-hard bearings.The nature of squeaking is not yet completely understood however it is considered a multifactorial phenomenon.Patient,implant,and surgical factors play a role in squeaking.It is believed that mechanisms damaging the fluid film lubrication in which these bearings function optimally have a critical role.Such mechanisms include edge loading,stripe wear,impingement,third body particles and ceramic fracture.The resonance of metallic parts can produce noise in the human audible range hence the implant metallurgic composition and design may play a role.Implant positioning can facilitate impingement and edge loading enhancing the occurrence of squeaking.The recent introduction of large heads(> 36 mm) 4th generation ceramic-on-ceramic bearing may accentuate the conditions facilitating noise formation; however the current literature is insufficient.Clinically,squeaking may manifest in extreme hip positions or during normal gait cycle however it is rarely associated with pain.Evaluations of patients with squeaking include clinical and radiographic assessments.Computer tomography is recommended as it can better reveal ceramic breakage and implant malposition.The treatments for most squeaking patients include reassurance and activity modification.However for some,noise can be a problem,requiring further surgical intervention.In the occurrence of ceramic fracture,implant failure,extreme components malposition,instability and impingement,surgery should be advised.This review will aim to discuss the current literature regarding squeaking.
文摘Objective： The present study aimed to review the characteristics and influencing factors of squeaking after ceramic-on-ceramic （CoC） total hip arthroplasty （THA） and to analyze the possible mechanisms of the audible noise. Data Sources： The data analyzed in this review were based on articles from PubMed and Web of Science. Study Selection： The articles selected for review were original articles and reviews found based on the following search terms： “total hip arthroplasty”, “ceramic-on-ceramic”, “hip squeaking”, and “hip noise.” Results： The mechanism of the squeaking remains unknown. The possible explanations included stripe wear, edge loading, a third body, fracture of the ceramic liner, and resonance of the prosthesis components. Squeaking occurrence is influenced by patient, surgical, and implant factors. Conclusions： Most studies indicated that squeaking after CoC THA was the consequence of increasing wear or impingement, caused by prosthesis design, patient characteristics, or surgical factors. However, as conflicts exist among different articles, the major reasons for the squeaking rernain to be identified.
文摘Background: Asian cultures require floor-seated positions demanding a high range of motion (ROM). Ceramic-On-Ceramic (COC) interface allowed the use of larger head with reduced wear debris generation and adverse tissue reactions. This study was conducted to analyze 6-year clinical-radiological outcome with large head fourth generation DeltaMotion®ceramic-on-ceramic (COC) hip articulation, with special emphasis on postoperative ROM, ability to sit cross-legged, stability, hip noise and revision surgery. Material and Methods: 150 consecutive hips were operated for primary cementless Total Hip Replacement (THR) using DeltaMotion®at a tertiary care center in Mumbai, India, between January 2010 and January 2015. Clinico-radiological outcome was assessed using the Harris Hip Score (HHS) and radiographs at 6 weeks, 6 months, and annually thereafter. Results: 108 (74.5%) patients were males and 37 (25.5%) were females with an average age of 50.87 years. Mean follow-up was 54 months (range: 37 - 86 months). The mean ROM was 120° in flexion, 10° in extension, 30° in adduction, 45° in abduction, 25° in internal rotation and 25° in external rotation. The mean HHS showed a statistically significant improvement of 64.5% (from 54.66 ± 6.42 pre-operatively to 89.95 ± 4.32 post operatively) (p-value: 0.001). 92% of patients were able to sit in squatting position and 92% were able to sit cross-legged on the floor at last follow-up. 0.7% joints (1 hip) had squeaking. Considering no revision surgery as the end point, 6-year prosthesis survivorship was 100%. Complications (superficial infection) occurred in three hips (2%). All patients reported to be satisfied with their outcome after surgery. Conclusion: We infer that DeltaMotion large head COC bearing allows scope for using larger head size in relatively smaller Indian hips due to factory fitted ceramic lining. At 6-year follow-up, high activity level was observed with excellent clinical-radiological outcomes and component longevity in relatively young Indian population.
