Squeaking, a high-pitch screeching sound, is a complication of ceramic-on-ceramic articulation in THA.


  1. Pathologic squeaking– squeaking that occurs in every step,
    -associated with anterosuperior edge loading secondary to excessive inclination & anteversion of the acetabular component,
    -more concern for pt. (anxiety, embarrassment), seeks further surgical intervention.
  2. Benign squeaking– squeaking that happens only with deep hip flexion,
                             – associated with posterior edge loading and
    -usually can be improved with pt. education(to avoid specifc positions & by reassuring the patient)

Cause of Squeaking- by loss of fluid film lubrication due to- a)edge loading (a result of either component malpositioning or, a well-positioned component at the extremes of motion); b)ceramic debris particles; c)damage to the bearing surface.

The combination of higher surface friction & a metallic stem, that can resonate, can produce an audible sound.

It is suggested by some to have an association between squeaking & higher wear rate & by others with ceramic fractures.

Assessment of Squeaking: by CT analysis-  evaluate component positioning & rule out any possible ceramic fractures.

An open discussion regarding bearing selection with the Pt is advocated before performing THA is performed; to reduce litigation against surgeons if bearing related complications occur.