J Arthroplasty. 2023 Aug 14:S0883-5403(23)00823-9. doi: 10.1016/j.arth.2023.08.027. Online ahead of print.
ABSTRACT
BACKGROUND: The noise associated with ceramic-on-ceramic (CoC) total hip arthroplasty (THA) has been a concerning issue, while its underlying causes remain unclear.
METHODS: We conducted a retrospective analysis of 119 patients (174 primary CoC THAs) who had a mean follow-up of 28 months (range, 12 to 106). A questionnaire was designed to collect information on nature, frequency, onset, duration, and impact of the noise. Post-operative x-rays were evaluated. Clinical evaluations, including Harris and Oxford hip scores, were documented at follow-up time points (6 weeks, 3 months, 6 months, and 1 year).
RESULTS: Of the 174 hips, 31.6% reported noise, including 26 popping (14.9%), 24 clicking (12.1%), and 5 grinding (2.9%). No patients reported squeaking. Noisy hips had lower age (P=0.009) and body mass index (P=0.019). Among developmental dysplasia of the hip patients, 17 of 55 hips reported noise associated with smaller cup anteversion angle (P=0.004), greater body height (P=0.022), and larger acetabular cup size (P=0.049). Noise typically began at a mean of 193 days (range, 1 to 2,598) days after surgery and disappeared spontaneously in 50.9% of hips before final follow-up, with an average disappearance time of 211 days (range, 60 to 730) days. Noise did not affect daily life in 74.5% of patients, while 26.9% of patients who had popping reported painful sensations. One patient experienced joint dislocation, and another experienced a ceramic liner fracture during follow-up. No statistical difference was observed in outcome scores between noise and silent groups at four follow-up time points.
CONCLUSION: Incidence of noise after primary CoC THA is relatively high. Smaller cup anteversion and larger acetabular cup size were associated with noise production in patients who had DDH.
PMID:37586597 | DOI:10.1016/j.arth.2023.08.027
