Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY10021, USA.
Clin Orthop Relat Res. 2011 Feb;469(2):437-42. doi: 10.1007/s11999-010-1574-3.
Alternative bearing materials in THA have been developed to reduce the incidence of osteolysis. Alumina-on-alumina bearings exhibit extremely low wear rates in vitro, but concerns exist regarding component impingement with the potential for dislocation and the occurrence of noise.
QUESTIONS/PURPOSES: We determined generation of squeaking and the relationship between squeaking and component position.
We prospectively entered 436 alumina-on-alumina, cementless, primary THAs in 364 patients into our institutional database. All procedures were performed with the same surgical technique and the same implant. We obtained Harris Hip scores and a noise questionnaire and assessed radiographic component position and loosening. We determined the difference in abduction angle between squeakers and nonsqueakers. Minimum followup was 2 years (average, 3.5 years; range, 2.0-6.2 years).
The mean Harris hip score increased from 51.9 preoperatively to 94.4 at latest followup. Six hips underwent reoperation: four hips (1.1%) for dislocation and two (0.53%) for periprosthetic fracture after trauma. The incidence of noise of any type was 11%, with the most common type of noise being clicking or snapping. Squeaking was reported by 1.9% of patients, with no patient being revised for this phenomenon. We found no association between component position and squeaking.
At average 3 years followup, 98% of ceramic-on-ceramic THAs did not require a revision, with 1.1% of hips having been revised for dislocation. Fewer than 2% of patients reported hearing an audible squeak, with no association found between component position and squeaking.
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
为了降低骨溶解的发生率，THA 中已经开发出了替代的承载体材料。氧化铝-氧化铝关节在体外表现出极低的磨损率，但存在部件撞击的风险，可能导致脱位和出现噪音。
问题/目的：我们确定了 squeaking 的产生以及 squeaking 与部件位置之间的关系。
我们前瞻性地将 364 名患者中的 436 例氧化铝-氧化铝、无水泥、初次 THA 纳入我们的机构数据库。所有手术均采用相同的手术技术和相同的植入物进行。我们获得了 Harris 髋关节评分和噪音问卷，并评估了放射学上的部件位置和松动情况。我们确定了 squeakers 和 nonsqueakers 之间的外展角度差异。最低随访时间为 2 年（平均 3.5 年；范围 2.0-6.2 年）。
平均 Harris 髋关节评分从术前的 51.9 分提高到了末次随访时的 94.4 分。六髋需要再次手术：四髋（1.1%）因脱位，两髋（0.53%）因外伤后假体周围骨折。任何类型的噪音发生率为 11%，最常见的噪音类型为咔哒声或卡嗒声。1.9%的患者报告有 squeaking 现象，但没有患者因这种现象进行了翻修。我们没有发现部件位置与 squeaking 之间的关联。
在平均 3 年的随访中，98%的陶瓷-陶瓷 THA 不需要翻修，1.1%的髋关节因脱位而进行了翻修。不到 2%的患者报告听到了可闻的 squeak，并且没有发现部件位置与 squeaking 之间的关联。
IV 级，治疗研究。有关证据水平的完整描述，请参见作者指南。
