Assessment of squeaking in total hip replacements

In vitro studies were conducted to investigate the incidence of squeaking in total hip replacements, examining ceramic-on-ceramic, ceramic-on-metal, and metal-on-metal bearings. Third-body debris materials were introduced into each bearing, and the incidence of squeaking was noted through simple friction studies. The addition of ceramic fragments caused squeaking in all bearings, although most significantly in the metal-on-metal bearings. The incidence of squeaking correlated well with elevated friction. It is proposed that squeaking in total hip replacement is related to adverse tribological conditions, where the lubrication of the implant is compromised.