A review of squeaking in ceramic total hip prostheses

The occurrence of audible squeaking in some patients with ceramic-on-ceramic (CoC) hip prostheses is a cause for concern. Great effort has been dedicated to understand the mechanics of the hip squeaking to gain a deeper insight into factors contributing to sound emission from CoC hip articulation. Disruption of fluid-film lubrication and friction were reported as the main potential cause, while patient and surgical factors, and design and material of hip implants, were also identified as leading factors. This article summarizes the recent available literature on this subject to provide a platform for future research and development. Moreover, high wear rates and ceramic liner fracture as viable consequences of hip squeaking are discussed.