Incidental discovery of an undisplaced ceramic liner fracture at total hip arthroplasty revision for squeaking - 31/07/13

Doi : 10.1016/j.otsr.2013.05.001

C. Dacheux ^a,^b,^⁎ , D. Bocquet ^a,^b, H. Migaud ^a,^b, J. Girard ^a,^b,^c
^a Service d’orthopédie C, hôpital Roger-Salengro, centre hospitalier régional universitaire de Lille, 59037 Lille cedex, France
^b Université Lille-Nord de France, 59000 Lille, France
^c Département de médecine sportive, université de Lille, 59045 Lille cedex, France

^⁎Corresponding author. Service d’orthopédie C, hôpital Roger-Salengro, centre hospitalier régional universitaire de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France. Tel.: +33 03 20 44 68 28; fax: +33 03 20 44 66 07.

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En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 31 July 2013
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Summary

Squeaking has been reported after ceramic-on-ceramic total hip arthroplasty (THA), but its pathomechanics is not fully understood. Impaired lubrication is suspected to be the main reason. The management of patients impacted by this phenomenon is not well defined and, as it is not considered to be cause for alarm, revision is not strongly recommended. Here, we describe a ceramic insert fracture discovered during revision surgery performed to correct severe squeaking. Preoperative investigation (plain X-rays, ultrasound and computed tomography) did not reveal ceramic fracture or definite component malposition. To date, there are no other published cases of incidental discovery of a bearing component fracture during revision of ceramic-on-ceramic hip replacement due to squeaking. We believe that squeaking is not a trivial phenomenon and recommend careful management of patients suffering with this symptom.

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Keywords : Squeaking, Ceramic failure, Total hip arthroplasty