Incidence ­of ­squeaking ­using­ third-generation­ Biolox®­delta ceramic ­on ­ceramic­ bearing­ surfaces

Main Article Content

Gerardo Zanotti
Martín Buttaro
Fernando Comba
Francisco Piccaluga

Abstract

Background: Squeaking is the most frequently related complication with ceramic on ceramic total hip arthroplasty. Third generation Delta ceramics present improved mechanical properties and so far squeaking has not been reported with this bearing surface. The aim of this study was to analyze the incidence of squeaking with the use of third-generation ceramics.Methods: This study included 109 hips in 97 patients, with an average age of 49 years (range 17-77 years), an average body mass index of 22.3 (range 19-48). One hundred and two hips were primary total hip arthroplasties, whereas 7 were revisions. Femoral and acetabular components were Pinnacle® (DePuy Orthopaedics, Warsaw, Indiana, USA). The ceramic used was BIOLOX® Delta (Ceram Tec AG, Plochingen, Germany) in all the cases.Results:­ Average follow-up was 37 months (range 24- 50 months). Radiographic assessment of the anteversion was made with the Ackland method (range 1°-35°). Inclination (range 22°-67°), acetabulum diameter (range 48-62), size of the femoral head (88 = 36 mm and 21 = 28 mm) and pre and post-operative offset were also evaluated. We observed 2 dislocations, 1 acute superficial infection, 1 periprosthetic fracture and 1 fracture of the ceramic acetabular insert due to incomplete seating of the acetabular liner. No patient referred noise or a squeaking hip.Conclusion: In this series, squeaking was not observed although the range of anteversion and inclination of the cups was widely variable. Due to its composition and design Delta Ceramic components may have a lower rate of squeaking than second-generation ceramics.  

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Article Details

How to Cite
Zanotti, G., Buttaro, M., Comba, F., & Piccaluga, F. (2014). Incidence ­of ­squeaking ­using­ third-generation­ Biolox®­delta ceramic ­on ­ceramic­ bearing­ surfaces. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 79(2), 124-130. https://doi.org/10.15417/252
Section
Clinical Research

References

1. Hamadouche D, Nich C, Bizot P, Meunier A, Nizard R, Sedel L. Fracture of ceramic bearing: history and present status.
Clin Orthop Relat Res 2003;417;19-26.

2. Yang CC, Kim RH, Dennis DA. The squeaking hip: a cause for concern- disagrees. Orthopedics 2007;30:739-42.

3. Rodriguez JA, Dela Valle A, McCook MS. Squeaking in total hip replacement: a cause for concern. Orthopedics 2008;31(9):
874-7.

4. Hamilton WG, McAuley JP, Dennis DA, Murphy JA, Blumenfeld TJ, Politi J. THA with Delta ceramic on ceramic. Clin
Orthop Relat Res 2010;468(2):358-66.

5. Lombardi AV Jr., Berend KR, Seng BS, Clarke IC, Adams JA. Delta ceramic-on-alumina ceramic articulation in primary
THA. Clin Orthop Relat Res 2010;468:367-74.

6. Walter WL, Insley GM, Walter WK, Tuke MA. Edge loading in third generation alumina ceramic-on-ceramic bearings: strip
wear. J Arthroplasty 2004;19:402-13.

7. Keurentjes JC, Kuipers RM, Wever DJ, Schreurs W. High incidence of squeaking in THAs with alumina ceramic-on-ceramic
bearings. Clin Orthop Relat Res 2008;466:1438-43.

8. Dennis DA, Komistek RD, Northcut EJ, Ochoa JA, Ritchie A. “In vivo” determination of hip joint separation and the forces
generated due to impact loading conditions. J Biomech 2001;34:623-9.

9. Nevelos J, Inghan E, Doyle C, Streicher R, Nevelos A, Walter W, et al. Microseparation of the centers of alumina-alumina
artificial hip joints during simulator testing produces clinically relevant wear rates and patterns. J Arthroplasty 2000;15:702-9.

10. Squire M, Griffin WJ, Mason JB, Peindl R, Odum S. Acetabular component deformation with press-fit fixation. J Arthroplasty
2006;21(6-Suppl 2):72-7.

11. Barrack RL, Thormberry RL, Ries MD, Lavernia C, Tozakoglou E. The effect of components design on range of motion to
impingement in total hip arthroplasty. Instr Course Lect 2001;50:275-80.

12. Jarrett CA, Ranawat AS, Bruzzone M, Blum YC, Rodriguez JA, Ranawat CS. The squeaking hip: a phenomenon of ceramicon-ceramic
total hip arthroplasty. J Bone Joint Surg Am 2009;91(6):1344-9.

13. Restrepo C, Parvizi J, Kurtz SM, Sharkey PF, Hozack Wj, Rothman RH. The noisy ceramic hip: components malpositioning
the cause? J Arthroplasty 2001;23:643-9.

14. Walter WL, O´Toole GC, Walter WK, Elis A, Zicat BA. Squeaking in ceramic-on-ceramic hips: the importance of acetabular
components orientation. J Arthroplasty 2007;379:22-8.

15. Ackland MK, Bourne WB, Uhthoff HK. Anteversion of the acetabular cup. Measurement of angle after total hip replacement.
J Bone Joint Surg Br 1986;68(3):409-13.

16. Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations After total hip-replacement arthroplasties.
J Bone Joint Surg Am 1978;60:217.

17. Streicher RM, Semlitsch M, Schoen R, Weber H, Rieker C. Metal-on-metal articulation for artificial hip joints: laboratory
study and clinical results. Proc Inst Mech Eng 1996;210:223-32.

18. Krushell RJ, Burke DW, Harris WH. Range of motion in contemporary total hip arthroplasty. The impact modular head-neck
components. J Arthroplasty 1991;6:97-101.

19. Chevillotte C, Trousdale RT, Chen Q, Guyen O, An Kai-Nam. “Hip Squeaking’’ A biomechanical study of ceramic-on-ceramic
bearing surfaces. Clin Orthop Relat Res 2010;468(2):345-50.

20. Capello WN, D´Antonio JA, Feinberg JR, Manley MT, Naughton M. Ceramic-on-ceramic total hip arthroplasty. J Bone Joint
Surg Am 2008;23:39-43.

21. Toni A, Traina F, Stea S, Sudanese A, Visentin M, Bordini B, et al. Early diagnosis of ceramics liner fracture. Guidelines
based on a 12 year clinical experience. J Bone Joint Surg Am 2006;88(Suppl 4):55-63.

22. Horzack WJ, Restrepo C, Parvizi J, Purtill JJ, Sharkey PF, Rothman RH. Noisy ceramic hip: is a components malpositioning
the problem? Presented at: 16th Annual Meeting of the American Association of Hip and Knee Surgeons; November 3-5,
2006; Dallas, Texas.

23. Langdown AJ, Pickard RJ, Hobbs CM, Clarke HJ, Dalton DJ, Grover ML. Incomplete seating of the liner with the Trident
acetabular system: a cause for concern? J Bone Joint Surg Br 2007;89(3):291-5.

24. Morlock M, Nassutt R, Janssen R, Willmann G, Honl M. Mismatched wearcouple zirconium oxide and aluminum oxide in
total hip arthroplasty. J Arthroplasty 2001;16:1071-4.

25. Buttaro MA, Zanotti G, Comba FM, Piccaluga F. Squeaking in a Delta ceramic-on-ceramic uncemented total hip arthroplasty.
J Arthroplasty 2012;27(6):1257-9.

26. Rieker CB, Schön R, Konrad R, Liebentritt G, Gnepf P, Shen M, et al. Influence of the clearance on in-vitro tribology of
large diameter metal-on-metal articulations pertaining to resurfacing hip implants. Orthop Clin North Am 2005;36(2):135-42.

Most read articles by the same author(s)

<< < 1 2 3 > >>