The Journal of Bone and Joint Surgery (American). 2008;90:112-120.
doi:10.2106/JBJS.H.00627
© 2008 The Journal of Bone and Joint Surgery, Inc.
Clicking and Squeaking: In Vivo Correlation of Sound and Separation for Different Bearing Surfaces
Diana Glaser, Dipl-Ing, PhD1,
Richard D. Komistek, PhD1,
Harold E. Cates, MD2 and
Mohamed R. Mahfouz, PhD1
1 Center for Musculoskeletal Research, Department of Mechanical, Aerospace, and
Biomedical Engineering, University of Tennessee, 301 Perkins Hall, Knoxville,
TN 37996. E-mail address for D. Glaser:
DGlaser@utk.edu
2 Tennessee Orthopaedics Clinic, 9430 Park West Boulevard Suite 130, Knoxville,
TN 37923
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Introduction
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Fluoroscopy has proven to be an accurate method to determine in vivo
motions1 and has
enabled the extraction of accurate three-dimensional hip-joint kinematics
unaffected by erroneous skin
movements1,2.
Previously, fluoroscopy was used to determine that the femoral head of a total
hip prosthesis slides within the acetabular cup, leading to separation of
certain aspects of the articular
geometry3-5.
This finding has often been referred to as hip separation, where there is a
loss of contact area, leaving only edge contact. Although separation has been
well documented, it has not been correlated to clinical complications nor has
a more in-depth understanding of the cause and effect been developed.
Another phenomenon observed primarily in total hip prostheses is the
presence of squeaking. Mismatched ceramic
couples6, acetabular
component
malposition7, and
impingement8 have
been proposed as factors in the development of squeaking. However, not all
mismatched and malpositioned components lead . . . [Full Text of this Article]

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