Ceramic-on-Ceramic Total Hip Arthroplasty and Noises: A Prospective Blinded Randomized Controlled Trial of Influence of Component Design

Rune T. Paulsen*, Peter H. Revald, Per Kjærsgaard-Andersen, Signe Timm, Claus Varnum

*Corresponding author for this work

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Background: Noises have been associated with ceramic-on-ceramic bearings in total hip arthroplasties. The etiology is multifactorial, but a high prevalence of noises was reported in studies using a specific acetabular component system. We examined if specific ceramic component designs are associated with the prevalence of noises in 2 commonly used component systems. We hypothesized that there would be no difference in noises between the 2 systems. Methods: In this randomized controlled trial, 2 different component designs with ceramic bearings were compared. Inclusion criteria were primary total hip arthroplasties, age between 18 and 65 years, and body mass index less than 35. The primary outcome was prevalence of noises, whereas secondary outcomes consisted of European Quality of Life index, visual analog scale, and University of California and Los Angeles activity scale. Follow-up data were collected at 3 and 12 months postoperatively. Data were available for 91 patients in Group 1 and for 92 patients in Group 2. Preoperative patient characteristics were comparable between groups. Results: At 12-month follow-up, the prevalence of noises was 19% in Group 1 and 14% in Group 2 (P = .41). European Quality of Life index were 0.89 in Group 1 versus 0.90 in Group 2 (P = .42). The visual analog scale was 81 in both groups (P = .88). When evaluating level of activity, University of California and Los Angeles activity scale scores were 8.2 in both groups (P = .92). Conclusion: At 12-month follow-up, there was no difference in the prevalence of noises between the 2 component designs.

Original languageEnglish
JournalJournal of Arthroplasty
Issue number3
Pages (from-to)734-738
Publication statusPublished - Mar 2024

Bibliographical note

Publisher Copyright:
© 2023 The Author(s)


  • ceramic-on-ceramic
  • component designs
  • noises
  • squeaking
  • total hip arthroplasty
  • Prospective Studies
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Hip Prosthesis
  • Arthroplasty, Replacement, Hip
  • Treatment Outcome
  • Ceramics
  • Prosthesis Design
  • Young Adult
  • Prosthesis Failure
  • Adolescent
  • Quality of Life
  • Adult
  • Aged


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