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Squeaking with a Total Hip Replacement

Ceramic materials have been used in total hip replacements for more than 30 years now. Improved materials and design have increased the popularity of this type of implant. But in a small number of patients, squeaking can occur.

In this article, surgeons from the Colorado Joint Replacement Center report on this problem. They review the studies done so far and report on the cause and how often this happens. Photographs and diagrams of the problem implant are included.

No one knows for sure what causes the hip to squeak with ceramic-on-ceramic implants. Special moving X-ray studies using fluoroscopy have helped identify some problems. Squeaking implants removed from patients have also been studied.

One type of implant seems to be involved most often: Trident by Stryker Orthopaedics. The extended rim on the socket side of the implant seems to be causing pinching of the femoral head and neck.

Other possible causes of hip squeaking may include decreased lubrication in the joint and a mismatch of the implant parts. The cause of a dry joint is unknown. To avoid mismatched components, the authors advise surgeons not to mix and match component parts from different manufacturers.

The squeaking is annoying but not usually painful. Sometimes it goes away on its own. This may happen if a small amount of polishing occurs on the ceramic surface. When the problem doesn't go away, surgery can be done to revise the implant. This isn't usually necessary.

Hopefully, continued improvements in design, materials, and positioning of the implant will take care of this problem in the near future.

References: Charlie C. Yang, MD, et al. The Squeaking Hip: A Cause for Concern. In Orthopedics. September 2007. Vol. 30. No. 9. Pp. 739-744.

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