Keurentjes J C, Kuipers R M, Wever D J, Schreurs B W
Department of Orthopaedic Surgery, Slingeland Hospital, Doetinchem, The Netherlands.
Clin Orthop Relat Res. 2008 Jun;466(6):1438-43. doi: 10.1007/s11999-008-0177-8. Epub 2008 Feb 26.
Ceramic-on-ceramic bearings in THA are a popular alternative to overcome wear concerns in traditional metal-polyethylene bearings. However, squeaking is a potentially worrisome phenomenon in ceramic-on-ceramic THAs which we observed in some of our patients. We reviewed all 42 patients who underwent 43 ceramic-on-ceramic noncemented THAs during the time of the study. Squeaking, defined as a reproducible sound of squeaking, clicking, or grating, occurred in nine of 43 implants (20.9%). Standard radiographs were normal. We used CT imaging to determine cup anteversion and inclination angles, comparing the squeaking hips with those of a randomly selected control group, but found no differences. We then hypothesized specific design features (stem size, cup size, head size, and neck length of the head) would be risk factors for squeaking. We found a difference in neck length between squeaking and nonsqueaking implants. A neck length of -4 mm or shorter resulted in a relative risk of 5.56 (95% confidence interval, 1.14-27.01) for squeaking. We found a high incidence of squeaking in our population, and we believe this phenomenon is an underreported side effect of these types of bearings. A short neck length of the femoral implant was a risk factor for squeaking in ceramic-on-ceramic THA.
Level III, therapeutic study.
在全髋关节置换术中，陶瓷对陶瓷轴承是一种受欢迎的选择，用以克服传统金属对聚乙烯轴承的磨损问题。然而，在我们的一些患者中观察到，陶瓷对陶瓷全髋关节置换术出现吱吱声是一个潜在令人担忧的现象。我们回顾了研究期间接受43例陶瓷对陶瓷非骨水泥型全髋关节置换术的所有42例患者。吱吱声定义为可重现的吱吱、咔嗒或摩擦声，在43个植入物中有9个出现（20.9%）。标准X线片正常。我们使用CT成像来确定髋臼前倾角和倾斜角，将出现吱吱声的髋关节与随机选择的对照组进行比较，但未发现差异。然后我们假设特定的设计特征（柄尺寸、髋臼尺寸、股骨头尺寸和头颈长度）会是出现吱吱声的危险因素。我们发现出现吱吱声和未出现吱吱声的植入物在头颈长度上存在差异。头颈长度为-4毫米或更短会导致出现吱吱声的相对风险为5.56（95%置信区间，1.14 - 27.01）。我们发现我们的患者群体中吱吱声发生率较高，并且我们认为这种现象是这类轴承未被充分报道的副作用。股骨植入物的头颈长度较短是陶瓷对陶瓷全髋关节置换术出现吱吱声的一个危险因素。
III级，治疗性研究。
