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. 2008 Nov;90 Suppl 4(Suppl 4):102-11.
doi: 10.2106/JBJS.H.00867.

Squeaking hips

William L Walter  1 , Tim S Waters, Mark Gillies, Shane Donohoo, Steven M Kurtz, Amar S Ranawat, William J Hozack, Michael A Tuke
Affiliations

Squeaking hips

William L Walter et al. J Bone Joint Surg Am. 2008 Nov.
No abstract available

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Figures

Fig. 1
Fig. 1
A computed tomography scan of bilateral ABG II ceramic-on-ceramic hip replacements (Stryker Howmedica Osteonics, Allendale, New Jersey). In the previously reported case of this patient, the right hip had excessive acetabular anteversion and it squeaked with walking. The left hip with ideal anteversion did not squeak. (Reprinted, with permission, from: Walter WL, O'Toole GC, Walter WK, Ellis A, Zicat BA. Squeaking in ceramic-on-ceramic hips: the importance of acetabular component orientation. J Arthroplasty. 2007;22:496-503.)
Fig. 2
Fig. 2
Box plot comparing the volumetric wear rate of the squeaking retrievals with that of a historical control.
Figs. 3-A Figs. 3-B
Figs. 3-A Figs. 3-B
Figs. 3-A through 3-D Previously described in a case report, these components were retrieved from a patient after sixty months because of pain and squeaking. (Reprinted, with permission, from: Murali R, Bonar SF, Kirsh G, Walter WK, Walter WL. Osteolysis in third-generation alumina ceramic-on-ceramic hip bearings with severe impingement and titanium metallosis. J Arthroplasty. 2008 Apr 2. E pub ahead of print.) Fig. 3-A There is evidence of impingement of the neck of the femoral component against the retrieved acetabular shell. Fig. 3-B Opposite the point of impingement on the rim, there is edge loading of the ceramic insert and a corresponding area of wear on the femoral head (the wear area has been colored with a blue surgical marking pen).
Figs. 3-C Figs. 3-D
Figs. 3-C Figs. 3-D
Fig. 3-C Closer inspection of the backside of the ceramic insert shows titanium metal transfer onto the edge. Fig. 3-D The titanium metal transfer onto the edge corresponds to a scored line (identified between the arrows) inside the titanium shell, evidence of tilting of the ceramic insert in the titanium shell.
Figs. 4-A 4-B
Figs. 4-A 4-B
Figs. 4-A and 4-B Finite element analysis of edge loading. Fig. 4-A The liner is in its normal position. Fig. 4-B The liner is “tilting” within the shell during edge loading.
Fig. 5
Fig. 5
This graph illustrates the Stribeck curves for different bearing combination materials. Under ideal in vivo conditions, we assume that a ceramic-on-ceramic (CoC) bearing will be operating with fluid film lubrication with a coefficient of friction of around 0.06. Metal-on-polyethylene bearings, on the other hand, operate under conditions of boundary lubrication with a coefficient of friction of around 0.04,, and an increase in contact pressure in this situation does not lead to an increase in the coefficient of friction. In ceramic articulations, a loss of fluid film lubrication may result in a coefficient of friction as high as 0.7 or 1.0. MoM = metal on metal.
Fig. 6
Fig. 6
A screen capture of the acoustic analysis software. In the spectral view at the top of the image, the squeak can be seen as a series of parallel lines. A fast Fourier transform of this squeak shows a harmonic series of frequency peaks with a fundamental at 1546 Hz. This is evidence of resonance.
Fig. 7
Fig. 7
Modal analysis of a thin-walled generic acetabular shell resonating in the (2,0) mode.
Fig. 8
Fig. 8
Graph representing the frequency of titanium shells resonating in the (2,0) mode. This design of titanium shell is typical in that the external diameter of the shell (which corresponds to the size in millimeters) changes by 2 mm every size, but the internal diameter changes every second size. Therefore, the thickness alternately increases and decreases usually by 1 mm. This results in a saw-tooth pattern.
Fig. 9
Fig. 9
Natural frequencies for this titanium stem are shown with and without a ceramic head attached. Attachment of the head makes very little difference to the frequency, although only the lower modes could be detected in some cases.
Fig. 10
Fig. 10
Graph of the natural frequencies of total hip replacement components. These frequencies, which were recorded in air, are modulated in vivo. The damping effect of the viscoelastic tissues tends to lower the frequency.
See this image and copyright information in PMC

References

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