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Ceramic-on-ceramic (COC) total hip arthroplasty (THA) was developed to reduce wear debris, and consequently the occurrence of osteolysis and aseptic loosening. The purpose of the present study was to determine the incidence and natural history of noise including squeaking after COC THA, and to clarify whether clinical outcomes and any demographic and implant-related factors are associated with noise from these ceramic bearings. This was a retrospective observational study of 137 primary COC THAs between 2004 and 2009 at our institute. The Mean follow-up was for 10.5 years. All patients were followed up with an office visit to obtain information regarding noise, pain, and function. The correlations between the noise, and patient demographic, radiographic, and implant-related factors were evaluated. Noise developed in 30 hips (21.9%), specifically squeaking in 2 (1.5%) of the 137 hips during the follow-up period. Noise including squeaking was not associated with pain or functional outcomes. There was significant correlation between noise and cup anteversion, in that cup anteversion of patients with noise was smaller than that in those without noise. No significant correlation was found between noise and any other patient demographic including age, sex, height, body weight, or body mass index. Kaplan–Meier survivorship analysis with revision for any reason and an aseptic loosening of either component as the end point, revealed a cumulative survival rate at 10 years of 98.4% and 99.1% respectively. The long-term clinical and radiographic outcome of cementless COC THA is excellent, but we should be vigilant for noise from COC bearings. [ABSTRACT FROM AUTHOR]

Introduction: Little is known about the association between well-fixed polished tapered cemented stems (PTCS) implanted by the line-to-line technique and changes of stem migration, or the change of functional anteversion of the femur after total hip arthroplasty (THA). Materials and methods: This retrospective study included 422 two-stage bilateral primary THAs performed using PTCS implanted by the line-to-line technique. CT scans were made on both the target side (first postoperative CT) and on the contralateral side (second postoperative CT) 1 week postoperatively. The mean follow-up was 7.8 months. CT data for each scan were transferred to 3D template software (Zed hip, Lexi, Japan). The postoperative changes of anatomical stem anteversion (ASA), functional femoral anteversion (FFA), and stem subsidence were evaluated. Results: A total of 20 THAs with CT scans were available on 3D template software. The ASA and the FFA had migrated − 0.68° ± 0.62° and − 5.5° ± 9.7°, respectively, over the follow-up period. A significant positive correlation was observed between the change of subsidence and ASA (r2 = 0.34, p = 0.007), between the FFA on the second postoperative CT and ASA on the first postoperative CT (r2 = 0.26, p = 0.02) and between the FFA on the second postoperative CT and FFA on the first postoperative CT (r2 = 0.52, p = 0.0003). Conclusion: This study indicates that the change in axial rotation of a PTCS implanted by the line-to-line technique was less than that reported by other studies and the preoperative external rotation contracture was substantially improved after THA. [ABSTRACT FROM AUTHOR]