A review of squeaking hips.

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Medical Device Engineering

Background:

• Squeaking in hip replacements, particularly with ceramic-on-ceramic and metal-on-metal bearings, is a recognized complication with unclear implications.
• Potential contributing factors include component malposition, edge loading, impingement, third-body particles, and lubrication issues.
• Hip joint squeaking is multifactorial, arising from interactions between patient, surgical, and implant variables.

Purpose of the Study:

• To explore the incidence and contributing factors of squeaking in hip replacement bearings.
• To outline management strategies for hip replacement squeaking, differentiating between conservative and surgical interventions.
• To discuss revision surgery options for persistent or problematic hip squeaking.

Main Methods:

• Literature review of studies investigating squeaking in hip arthroplasty.
• Analysis of contributing factors such as component positioning, bearing materials, and surgical technique.
• Evaluation of clinical outcomes for conservative management versus surgical revision.

Main Results:

• Squeaking incidence varies between ceramic-on-ceramic and metal-on-metal bearing types.
• Identified contributing factors include malalignment, edge loading, impingement, and particulate debris.
• Conservative management is advised for infrequent squeaking without functional impairment.

Conclusions:

• Hip replacement squeaking is complex and multifactorial, requiring a holistic assessment.
• Surgical intervention is indicated for persistent squeaking, component malposition, implant failure, impingement, or pain.
• Revision surgery may involve bearing exchange to ceramic-on-ceramic or ceramic-on-polyethylene options.