Prevalence and characteristics of noise in a series of 282 ceramic-on-ceramic total hip arthroplasties.

OBJECTIVE

The aim of this study was to determine the prevalence of noise with ceramic-on-ceramic (COC) bearings in total hip arthroplasty (THA). We evaluated if patients wished be counseled about this and its potential consequences preoperatively.

METHODS

Two hundred eighty-two primary cementless THAs were performed in 260 patients (124 males and 136 females), with a mean age 68.5 years. All patients completed a questionnaire. Minimum follow-up was 3 years. Statistical analysis was used to evaluate if patient variables influenced whether the patient experienced a noisy hip.

RESULTS

Thirty-one (11%) of hips had an audible noise; 50% of these were 'squeaks.' The noise was mainly present upon standing up (74%) and walking (45%). None of the patients noted 'noise' on their consent forms. Fifty-five percent of the entire cohort would have preferred to have known about the possibility of a noisy hip before consenting, though no patients would have refused consent had they known about the noise preoperatively. No patients have sought financial compensation to date. There was no significant influence of gender (p=0.92), age (p=0.66), height (p=0.17), weight (p=0.99), or body mass index (p=0.29) on whether the patient experienced a noisy hip.

CONCLUSION

No patient factor associated with noise could be identified. It is suggested that this issue be discussed preoperatively with all patients. In our cohort, this would satisfy the majority of patients' wishes and may additionally serve as important evidence in a malpractice claim. Therefore, it is suggested that the British Orthopaedic Association include 'the possibility of noise' in their consent form for THA.