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Large-diameter ceramic bearings offer positive results for THA despite tendency to squeak

by Monica Jaramillo

Although the use of large-diameter ceramic bearings for total hip arthroplasty produced squeaking in certain cases, early postoperative results were encouraging, according to study researchers.

The researchers reviewed data from 178 patients who underwent total hip arthroplasty in 189 hips, with an average follow-up of 28 months. Patients had been assessed preoperatively and at follow-up at 6 weeks, 6 months and 2 years to examine range of motion and Harris Hip Score (HHS). Additionally, squeaks and other noises, as well as complications, were recorded.

The researchers analyzed preoperative and postoperative radiographs of squeaking hips to determine leg length restoration, offset and center of rotation — factors reported in other studies to have an association with the incidence of squeaking. Additionally, anteroposterior pelvic and lateral radiographs were used to assess cup inclination and anteversion.

Results showed mean HHS improved from 54 points preoperatively to 92 points postoperatively, with 175 hips observed to have excellent results, five hips observed to have fair results and nine hips observed to have poor results. Although there were 15 squeaking hips, none required revision, and no correlation was observed between cup inclination increases, anteversion and squeaking, according to the researchers.

The researchers found patients experienced squeaking more often when a femoral head size of 48 mm was used, but the differences between occurrences of squeaking and varied head sizes were not considered significant. Additionally, cup inclination and anteversion were not observed to be different between squeaking hips and nonsqueaking.

With regard to leg length restoration, offset and center of rotation, no significant differences were observed between squeaking hips and nonsqueaking hips, according to the researchers.

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