Computer Navigation Helps Reduce the Incidence of Noise After Ceramic-on-Ceramic Total Hip Arthroplasty

• Published in: The Journal of arthroplasty Vol. 32; no. 9; pp. 2783 - 2787
• Main Authors: Shah, Siddharth M., MS (Orth), Deep, Kamal, FRCS (Tr & Orth), Siramanakul, Chaiyaporn, MD, Mahajan, Vivek, MS (Orth), Picard, Frederic, FRCSEd, Allen, David, FRCSEd
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2017
• Subjects: Aged; Arthroplasty, Replacement, Hip; ceramic-on-ceramic; Ceramics; computer navigation; Diagnosis, Computer-Assisted; Female; Hip Prosthesis; Humans; Image Processing, Computer-Assisted; Incidence; Male; Middle Aged; Noise; Orthopedics; Prospective Studies; Software; squeaking; total hip arthroplasty; User-Computer Interface; computer navigation; total hip arthroplasty; ceramic- on- ceramic; picture archiving and communications system; squeaking; PACS; COC; body mass index; noise; THA; BMI; ceramic-on-ceramic
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2017.04.019

Abstract Background Noise after ceramic- on- ceramic (CoC) total hip arthroplasty (THA) is a well recognized problem. Computer navigation has been shown to achieve desired implant orientation. Our aim was a) to compare the incidence of noise between navigated and conventional CoC THA; b) to determine the factors associated with noise. Methods All patients undergoing CoC THA during March 2009- August 2012 were considered for this study. Information regarding hip noise was obtained via telephone/ postal interview. A comparable cohort of patients in navigated and conventional groups was used to evaluate the incidence of noise. Results A total of 375 CoC THAs using the same implant (202 navigated; 173 conventional) were evaluated. Patients <65 years of age had significantly greater incidence of noise (22.4% vs. 6.1%; p<0.001). To ensure similarity, a subgroup of cohort of <65 years and 32mm head size was used to compare the incidence of noise between navigated (68 THAs) and conventional (118 THAs) groups. Overall incidence of noise was significantly greater in the conventional group (28%) as compared to navigated group (10%; p=0.005). Relative risk for noise for conventional vs. navigated group was 2.7 (p=0.01), and for squeaking was 1.9 (p=0.2). Squeaking THAs had significantly lower cup anteversion (13.4°± 5.2°) as compared to silent THAs (17.6°± 6.9°; p=0.01). Conclusion Navigated CoC THAs were 2.7X less likely to have noise as compared to conventional ones. Squeaking THAs had significantly lower cup anteversion as compared to silent ones. Patients<65 years had significantly greater incidence of noise after CoC THA.