The Rothman Institute of Orthopaedics at Thomas Jefferson University Hospital, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107, USA.
Clin Orthop Relat Res. 2010 Sep;468(9):2340-5. doi: 10.1007/s11999-009-1223-x.
In recent years, a number of alternative bearing surfaces, such as ceramic on ceramic, are being used in THA. Squeaking after THA is a recently recognized complication; however, its incidence is unknown.
QUESTIONS/PURPOSES: Find the incidence of squeaking; when it ensues; activities associated to squeaking; its natural history, and outcome of revisions for squeaking.
A prospective observational study between 2002 and 2007; yield 1486 ceramic-on-ceramic THA performed at our institution. All patients were followed up by office visits or by phone, to obtain information regarding squeaking, pain and function. Minimum followup was 2.5 years (mean, 5.5 years; range, 2.5-7.9 years).
Ninety-five of the 1486 hips (6%) developed squeaking after THA, 39 females (44%) and 49 males (56%) with an average age of 49.9 years. Squeaking began on average 19.7 months after surgery but not associated with pain or functional impairment in any patient. Squeaking could be heard during walking (38%), ascending stairs (24%), bending forward (21%), and other activities (18%), was constant in 26% of the patients and intermittent in 74%. The intensity and frequency remained similar over time in 70% of the patients.
Squeaking is a real phenomenon that occurred in about 6% of our patients. The etiology for this problem remains elusive and is likely to be multifactorial in nature. Squeaking, when developed, does not seem to be self-limited and persists in the majority. Nine patients underwent revision arthroplasty for squeaking. No fractures or other implant-related issues were observed.
Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
近年来，许多替代的关节面，如陶瓷对陶瓷，被应用于全髋关节置换术（THA）。THA 后出现弹响是一种新认识的并发症，但发病率尚不清楚。
问题/目的：确定弹响的发生率、出现时间、与弹响相关的活动、其自然病史以及因弹响而进行翻修的结果。
这是一项 2002 年至 2007 年期间进行的前瞻性观察性研究，共纳入了我院实施的 1486 例陶瓷对陶瓷 THA。所有患者均通过门诊或电话随访获得有关弹响、疼痛和功能的信息。最低随访时间为 2.5 年（平均 5.5 年；范围 2.5-7.9 年）。
1486 例髋关节中，95 例（6%）在 THA 后出现弹响，其中 39 例为女性（44%），49 例为男性（56%），平均年龄为 49.9 岁。弹响平均在手术后 19.7 个月开始出现，但没有引起任何患者疼痛或功能障碍。弹响可在行走时（38%）、上楼梯时（24%）、弯腰时（21%）和其他活动时（18%）听到，在 26%的患者中为持续存在，在 74%的患者中为间歇性存在。70%的患者中，弹响的强度和频率随时间推移保持相似。
弹响是我们的患者中确实存在的一个问题，发生率约为 6%。其病因仍不清楚，可能是多因素的。出现弹响后似乎不会自行缓解，且在大多数患者中持续存在。9 例患者因弹响而接受了关节翻修手术，未观察到骨折或其他与植入物相关的问题。
Ⅱ级，预后研究。有关证据水平的完整描述，请参见作者指南。
