Squeaking and Ceramic THR Devices
Link http://www.topix.com/forum/health/hip-replacement/T1JC8KCMUNDSV55OL
I have a Stryker ceramic and titanium hip replacement and have had it since 10/2/03 I first noticed the squeak while making love, it worsened: and going up stairs is actually quite noisy. With one foot on a chair, raising my weight with the replaced hip, it sounds like a rusty gate hinge and emits a about a 2 octave range.
Here is the response I got from Stryker when I Emailed them about my sonorus astabularium:
A few patients with ceramic-on-ceramic hips report that in certain situations, they hear a noise, or squeaking, emanating from the hip. Surgeons have also reported on patients who reported noise during very specific activities, such as rising from a chair or walking up stairs, and that often the noise will disappear spontaneously. The number of reports is low in relation to the number of components implanted.
The reported noise has never been shown to be a mode a failure of the components. However, the perception of the noise is a concern because it affects patients quality of life. While Stryker Orthopaedics has not been able to identify the cause of the reported noise, we are continuing to evaluate all reports and keeping a dialogue with clinicians.
Regards,
Stryker
My Dr. has researched this issue and talked to the manufacturer and others involved in the testing of the ceramic on ceramic hips. He had never heard of this until my case presented itself. He says pretty much what has been said above. The company has told him that a squeak has developed in fewer than 100 cases (perhaps underestimated?), that it usually goes away, and that it has not caused a failure of a hip. There is no way to reduce or manage the sound. He says that there are no existing studies on this issue. I will be seeing my Dr. this week and may get more info.
My hip has been squeaking for 10 months now. It has gotten steadily louder and more frequent. It squeaks when I lean over, when I lift up my leg to put my pants on, when I lift something heavy, and when I walk. It now squeaks on almost every step as I walk unless I take very small steps. I have started limping at my office to try to keep the sound quiet in order not to draw attention to myself. I enjoy walking less than I used to. I cannot do certain exercises at the gym (like squats) because of the noise.
It is interesting to hear other stories and realize that this is a more common problem than it seems. The reason I got the ceramic hip is because it was supposed to last a lifetime. Now I’m thinking about having it replaced.
Here is a May 3, 2006 article from www.Macleans.ca
Hip replacement may cause squeaking
Australian surgeons find that some of their patients emit a high-pitched noise when they walk
A small percentage of people who receive a ceramic total hip replacement will emit a painless high-pitched noise when they walk or bend over, according to Australian surgeons.
In some cases, recipients may find this squeaking so bothersome they opt to have the implants replaced, according to Dr. Gary O’Toole, a New York-based orthopedic surgeon and former fellow with Sydney Hip and Knee Surgeons in Australia.
From 1997 to 2005, the surgeons encountered 13 cases of squeaking among nearly 2,400 patients who received a first ceramic-on-ceramic hip replacement. These implants replace the ball-and-socket joint of the hip with corresponding parts made from a very hard, smooth type of ceramic.
The chances that someone would develop a squeaky hip were low, at only one-half of one per cent. But one patient, a schoolteacher, couldn’t tolerate the squeaking and requested a re-operation.
“Every time there was any kind of quietness in the classroom and she was walking up and down the classroom aisle, she squeaked, and she was a subject of ridicule among the students,” O’Toole says.
“Most of the patients have a lifestyle whereby they can accommodate the squeak.”
Squeaking started anywhere from four to 50 months after surgery, and could occur while bending, immediately upon starting to walk or after prolonged walking.
Patients who squeaked while bending could avoid the problem by favouring the affected hip. For example, patients whose left hip squeaked when they bent over with the left foot forward could usually prevent the squeak by placing the right foot forward while bending.
O’Toole and his colleagues report that suboptimal positioning of the hip implants caused some but not all cases of squeaking. The schoolteacher’s hip was in “perfect” orientation, but she had signs of wear on her implants, possibly caused by soft tissue interfering with the motion of the joint.
Q&A from Dance Magazine, May 2005
I’M HAVING SQUEAKING ISSUES! AFTER A TOTAL HIP REPLACEMENT WITH A CERAMIC-LINED TITANIUM SOCKET AND TITANIUM “BONE” WITH CERAMIC BALL, MY HIP LITERALLY SQUEAKS LOUD ENOUGH FOR MY STUDENTS TO HEAR IT WHEN I TEACH. THERE’S NO PAIN AND MY SURGEON HAS FOUND NOTHING WRONG IN FOLLOW-UP X-RAYS. YET IT MAKES ME NERVOUS AND IS EMBARRASSING WHILE TEACHING. WHAT CAN I DO?–MARLA HANSEN, BOISE, IDAHO
I’m so sorry. It’s bad enough for dancers to have hip replacements without the extra stress of strange side effects like squeaking. Though there’s little information on this problem, Dr. Jack Henry, past president of the Southern Orthopedic Association, says that a ceramic on ceramic (or metal on metal) hip replacement can rattle. The good news is that you aren’t in pain, which is a possible complication with all replacements.
Linda Hamilton
My wife had a total hip replacement in June 2005. In May of this year, she came in from light yard work complaining that something had slipped and she was squeaking, which she was. After an emergency room visit, we returned to her surgeon’s office. His report:X-rays show “the femoral component appears to be well seated as well as her cup but here is a superior migration of the head and wear of the liner. This is an interval change from last year. Assessment & Plan: Premature wearing of the liner. This is unusual in that she has only had it in a year. She does have a cramic head and it is larger. It is a 32 mm head. In my opinion she will need revision of this. Hopefully just a revison of the liner and the head ball but we would have to be prepared to revise the other components as well. I think she owuld be best served by a revsion specialist and we will set that up for her in Atlanta.” She is still squeaking and has been instructed to take small steps to avoid a possible total dislocation. Needless to say, we are quite upset. The implants were DePuy Summit size 4 stem and Pinnacle cup size 48, 32 mm ceramic head ball, and extended offset ten degree posterior linced acetabular liner. Any feedback would be welcome.
I too have the squeaking hip. I had bilateral totals hips with the ceramic component. The squeaking is quite loud and very annoying. My problems is compounded by a nerve injury that left me with a foot drop post-op. This problems is miserable and would like to hear options that don’t require revision surgery. I’ve already had an additional surgery because of the foot drop that was unsuccessful; another hip surgery would be devastating to me at this point.