Orthopedic & Muscular System: Current Research
Open Access

Abstract

Clicking of a Total Hip Arthroplasty due to Posterior Impingement: An Unusual Situation and Review of the Literature about Common Noises in Total Hip Arthroplasties

Massazza G, Ravera L, Giordano A, Drocco L, Lagalla F, Graziano E, Galetto F, Collo G and Bistolfi A

Introduction: The success of ceramic implants is attributed to the excellent properties of this material associated with superior wear rates and a chemically inert nature which grants it biocompatibility and greater longevity compared with the traditional metal-on-polyethylene bearing surface. However, there have been an increasing number of reports on audible noises that seemed linked to these hard bearing surfaces, leading some to believe the implant material or design was still to blame.

Case report: In this paper is presented the case of an unusual noise which occurred in a 73 year old woman 6 years after THA implant.

Discussion: We hypothesized that the possible cause of this “click” was the impingement of the neck of the stem against the acetabulum ream or as an other possibility some sort of movement between the metal back and the acetabular ceramic liner. During the revision surgery the first hypothesis have been confirmed. Thus, we believed that correcting the position of the cup could reduce the possibility of the clicking caused from the impingement.

Conclusion: Noise in ceramic-on-ceramic THRs is not a single factor related event but rather it is a multifactorial phenomenon. Although several theories have been suggested, the mechanisms responsible has not yet clearly identified.