Department of Orthopaedic Surgery, Hanyang University Seoul Hospital, Seoul, South Korea.
Clin Orthop Relat Res. 2010 Dec;468(12):3234-9. doi: 10.1007/s11999-010-1394-5.
The alumina-on-alumina bearing surface, which has a high wear resistance and a good biocompatibility, is widely used in THA but recently has been associated with squeaking. While various authors have reported factors associated with squeaking, they remain poorly understood.
QUESTIONS/PURPOSES: To contribute to the debate on squeaking we therefore asked the following questions: (1) What is the incidence of squeaking in alumina-on-alumina THA? (2) What factors are associated with squeaking in alumina bearings in our practice?
We retrospectively reviewed 168 patients (173 hips) who had primary alumina-on-alumina THAs. The mean age of the patients was 53 years (range, 18 to 81 years). Minimum followup was 5.6 years (average, 7.3 years; range, 5.6-9.4 years). All patients were evaluated clinically and radiographically with attention to periprosthetic osteolysis, squeaking, and ceramic fracture. When the patient reported squeaking, we determined the onset, reproducibility, and activities associated with the squeaking. We recorded patient (gender, age, height, weight, and body mass index) and surgical factors (abduction angle of cup, size and length of ceramic head component, and diameter of cup in the implant).
Eight of the 168 patients (5%) had squeaking hips. Squeaking was more common in males and in those with large ceramic heads. There were no complications or revisions in the squeaking group. One ceramic liner fracture was associated with trochanteric nonunion.
When recommending alumina-on-alumina bearing surfaces to patients they should be clearly informed of the possibility of squeaking. Patients with risk factors for squeaking should be followed at regular intervals.
氧化铝对氧化铝的轴承表面具有高耐磨性和良好的生物相容性，因此被广泛应用于全髋关节置换术，但最近与嘎吱声有关。虽然许多作者报告了与嘎吱声相关的因素，但它们仍然知之甚少。
问题/目的：为了对嘎吱声的争论做出贡献，我们提出了以下问题：（1）氧化铝对氧化铝全髋关节置换术中嘎吱声的发生率是多少？（2）在我们的实践中，哪些因素与氧化铝轴承的嘎吱声有关？
我们回顾性分析了 168 例（173 髋）初次行氧化铝对氧化铝全髋关节置换术的患者。患者的平均年龄为 53 岁（范围，18-81 岁）。随访时间至少为 5.6 年（平均 7.3 年；范围，5.6-9.4 年）。所有患者均进行临床和影像学评估，包括假体周围骨溶解、嘎吱声和陶瓷骨折。当患者报告有嘎吱声时，我们确定了嘎吱声的出现、可重复性和与嘎吱声相关的活动。我们记录了患者（性别、年龄、身高、体重和体重指数）和手术因素（杯的外展角、陶瓷头组件的大小和长度以及杯的直径）。
168 例患者中有 8 例（5%）出现嘎吱声髋。嘎吱声在男性和陶瓷头较大的患者中更为常见。在嘎吱声组中没有并发症或翻修。1 例陶瓷衬垫骨折与转子间不愈合有关。
在向患者推荐氧化铝对氧化铝轴承表面时，应明确告知其嘎吱声的可能性。有嘎吱声风险因素的患者应定期随访。
