Stripe Wear and Squeaking in Ceramic Total Hip Bearings

Alumina ceramic-on-ceramic bearings have very low wear rates in standard hip simulators. However retrieved bearings demonstrate edge loading wear. We analyzed 16 retrieved bearings. The average wear volume was 0.4 mm3/year in the femoral heads. Acetabular anteversion of less than 15° was associated with an increased wear rate. Rarely patients complain of squeaking from their hip replacement. Of hip arthroplasties that squeak, those that squeak in extension have more anteversion (40°) than those that squeaked in flexion (19°). The incidence of both stripe wear and squeaking will be reduced by accurate placement of the hip components.