Bellity Jonathan, Elkaïm Marc, Hannouche Didier, Nizard Rémy
Department of Orthopaedic Surgery, Lariboisière, Hospital, Paris 7 University, Paris, France.
Department of Orthopaedic Surgery, Geneva University Hospitals & Faculty of Medicine, Avenue Gabrielle Perret Gentil 4, 1205, Geneva, Switzerland.
BMC Musculoskelet Disord. 2020 Dec 3;21(1):805. doi: 10.1186/s12891-020-03817-x.
Squeaking of ceramic-on-ceramic total hip arthroplasty is an unexpected complication which occurs in 1- 30% of patients. Revision surgery is required in 0.2% of the cases, when a ceramic fracture is suspected, or in case of severe malposition of the implants, subluxation, or impingement. Hip arthroscopy may be a useful diagnostic and therapeutic option in squeaking hips.
A patient presenting with a pain-free squeaking underwent hip arthroscopy to examine the sliding surfaces and the rim of the acetabulum, and to search for signs of impingement. Thorough lavage and debridement of hip synovitis and fibrous tissue was performed. The squeaking noise immediately disappeared after the surgery. The patient was allowed to fully weight bear as tolerated with 2 crutches for 2 weeks. Two years after the arthroscopy, the patient remained symptom-free.
The potential reasons for hip squeaking in our patient are discussed. Hip arthroscopy may prove useful as a diagnostic and therapeutic option for some patients presenting with a squeaking ceramic-on ceramic hip replacement.
陶瓷对陶瓷全髋关节置换术后出现的摩擦音是一种意外并发症，发生率为1%至30%。当怀疑陶瓷部件骨折，或植入物严重位置不当、半脱位或撞击时，0.2%的病例需要进行翻修手术。髋关节镜检查对于有摩擦音的髋关节可能是一种有用的诊断和治疗选择。
一名无痛性摩擦音患者接受了髋关节镜检查，以检查滑动面和髋臼边缘，并寻找撞击迹象。对髋关节滑膜炎和纤维组织进行了彻底冲洗和清创。术后摩擦音立即消失。患者在能耐受的情况下允许完全负重，使用双拐2周。关节镜检查两年后，患者仍无症状。
讨论了我们患者髋关节出现摩擦音的潜在原因。对于一些陶瓷对陶瓷髋关节置换术后出现摩擦音的患者，髋关节镜检查可能是一种有用的诊断和治疗选择。
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