Audiogram of ceramic friction noises in total hip arthroplasty and their relationship with acetabular component position

Introduction Noise from a total hip replacement's ceramic friction pair is known as hip squeaking. Acoustic arthrometry in total hip replacement (THR) involves using acoustic emission technology to visualize sound characteristics.

The objective was to identify the possibility of identifying noises of a THR ceramic friction pair using the acoustic arthrometry and to determine the relationship of noises with the position of the acetabular component.

Material and methods The retrospective study included 36 patients who underwent THR with a ceramic bearing pair. Seven patients (19.44 %) reported noise at the site of the THR joint. The patients were divided into two groups based on the noise (n = 7) and no noise reported (n = 29). Clinical and radiological parameters were reviewed through online survey considering age, follow-up period, BMI, inclination and anteversion of  the  acetabular component. Acoustic arthrometry was performed for 10 patients with the pulse height, PEAK, ASYMMETRY and WIDTH measured and compared.

Results Comparative analysis of individual clinical and radiological parameters showed no statistically significant differences in the two groups. However, deviations by any of the two criteria in the acetabular component position was 20.7 % in the no-noise group and 57.1 % in the noise reported group (p = 0.048). Acoustic emission of THR with noise had visual differences in acoustic signature with the mean PEAK measuring 0.492 in the no-noise group and 0.488 in the noise reported group; ASYMMETRY being 0.012 versus 0.015 and WIDTH measuring 479.2 versus 486.5, respectively. Discussion The findings correlated with the results of previous studies and confirmed the relationship between the angles of the implanted acetabular component and the noise. In contrast to previous studies of  acoustic arthrometry, the method offered facilitated objective statistical noise assessment in addition to visualization and analysis of acoustic signatures.

Conclusion The study demonstrated possibilities of acoustic arthrometry in identification of different states of the ceramic friction pair, characterization of the noise detected and its quantification.

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