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I work as an aide in a nursing home. I noticed that two of our residents who have hip replacements make a squeaking or popping noise when they go up the three little steps we have to our dining area. Is this normal? Should I ask them about it? I don't want to bring up something they can't hear or don't notice. But I keep thinking maybe something is wrong.

You can certainly bring it to the attention of the nursing staff who will know whether or not to pursue the problem further. Although it is not a normal result of hip replacement, it can be considered a postoperative complication. It occurs in one to 10 per cent of adults with hip replacements. There's no evidence to suggest that the noises mean the implant will fracture or fail sometime in the future. But it's the type of thing that should be noted and followed or monitored carefully. There usually isn't any pain associated with the noise, which is why the residents may not have noticed it. For most patients who develop noises after having a hip replacement, activities that reproduce the noises include bending and walking (most common), but also climbing stairs, exercising, during sexual activity, and when putting on pants. Some of the patients can make the noise by stepping up on a low stool. This is actually called the squeak test. Evidently, combining a flexion-to-extension movement of the hip with a weight-bearing load is enough to recreate the problem. That's most likely what you are observing when the residents are stepping up into the dining area.

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