Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Schiller, B.
Squeaking ceramic-on-ceramic total hip arthroplasties:
3D analysis of CT scans
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2018. pp. 71
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Friesenbichler Jörg
- Maurer-Ertl Werner
- Altmetrics:
- Abstract:
- Inroduction: Although the success rate of total hip arthroplasty is high, the occurrence of audible sounds during movement of the hip joint, commonly referred to as squeaking, remains to be an ongoing concern with ceramic-on-ceramic bearings. Different studies have proposed and investigated implant positioning as one important factor, but there have been varying results. The primary aim of this study was to investigate if implant positioning is linked to noise generation. The combined anteversion, calculated by adding the acetabular anteversion to the femoral anteversion, was of particular interest. The secondary aim was to establish a database for future research on noisy hip prostheses, which includes various information like demographic data, scores, a specific questionnaire, exact descriptions if and how different types of noise could be provoked, types and sizes of the prosthesis components, clinical assessment of the radiographs, measurements of implant position in 2D and 3D and Einzel-Bild-Röntgen-Analyse – Femoral-Component-Analysis (EBRA-FCA). If participants still had a non-operated hip joint on the contralateral side, it was also measured, to collect data about the natural configuration of these joints. Materials and Methods: A case group of 20 patients was compared to a control group of 21 patients. MediCAD hip 3D® (Hectec) was used to measure implant position from CT scans. The investigated prostheses consisted of a Corail® (DePuy Synthes) stem and Pinnacle® (DePuy Synthes) cup with ceramic-on-ceramic bearings, that were implanted at the Department of Orthopaedics and Trauma -Medical University of Graz from 2005 to 2012. Results: The statistical analysis did not show a significant correlation between the two groups regarding implant position, demographic data or radiological assessment. A significant difference was found when comparing the natural hip joints. The case group had higher combined (p = .029) and acetabular (p = .046) anteversion angles, but the available data was limited (case group n=11, control group n=6). Conclusions: This suggests that for patients with exceptional anatomical properties, a standardized anatomical reconstruction with prosthesis implantation might result in suboptimal biomechanics, which subsequently leads to a higher incidence of noise.