"Squeaky Hip": Are Noises Important?

We report on an 82-year-old female who developed painless "squeaking" and a grinding sensation 23 years after a ceramic-on-metal total hip arthroplasty. Radiographs revealed linear wear through the polyethylene insert. During revision, we replaced the acetabular construct with a dual mobility system. Intraoperatively, the acetabular bone damage was significant but contained, and the ceramic head had atypical wear after the polyethylene liner broke and was articulating directly with the titanium shell. The metallosis in the surrounding tissue was surprisingly minimal despite direct ceramic-on-metal contact. At 1-year follow-up, the patient recovered excellent function with complete noise resolution. This case establishes the importance of "listening" to your joints. New onset noise in any bearings should prompt urgent evaluation, allowing for timely intervention before significant damage occurs.