The squeaking hip: a cause for concern-disagrees.

Total hip arthroplasty with ceramic-on-ceramic bearing surfaces has demonstrated low wear with excellent clinical outcomes. More recently, concerns have surfaced because of the presence of audible squeaking in some ceramic-on-ceramic THA patients. The incidence of this phenomenon has been low and has infrequently required reoperation. The exact etiology of squeaking remains unclear but is likely related to variations in surgical technique, patient selection, and implant design, particularly those designs that result in premature femoral neck-acetabular component rim impingement such as the presence of modular ceramic liner designs that are placed within a titanium encasement which has an extended rim. Hopefully, with continued improvements in design, materials, and component positioning, squeaking following ceramic-on-ceramic THA can be minimized.