Total hip replacements have come a long way, and Dr. Todd Swanson, Las Vegas, NV, pioneered many of the advances including the mini-incision total hip replacement that utilizes a mere 3-4 inch incision and has patients up and putting weight on the hip immediately. Full recovery takes a fraction of the time compared to older techniques, and many people return to sedentary jobs in 1-2 weeks.
“We were so excited about the mini-incision results, the greatly reduced recovery time and the increased longevity of the ceramic-on-ceramic hip replacements. Then, after implanting around 50 ceramic hips of a particular brand in 2004, we began noticing loud squeaking in some of them,” says Todd Swanson, MD, innovator of the mini-incision total hip replacement surgical procedure and director of the Desert Orthopaedic Research Foundation. “As the number of squeaky hips began to escalate, it became important to isolate the cause and relieve the concern for patients,” Dr. Swanson comments.
From November 1999, to February 2007 Dr. Swanson implanted 306 ceramic-on-ceramic total hip replacements in 267 patients utilizing 4 different brands: 1) Plus Orthopedics, 2) Stryker Orthopedics, 3) Wright Medical and 4) Encore Orthopedics. In the study, 233 patients with 270 total hips were contacted by telephone to complete a survey regarding squeaking of their hip replacement.
Frequency and severity as well as other independent variables were surveyed and rated. Frequency ranged from a squeak less than once per week to daily and severity ranged from perceptible only to the patient to loud--creating a social problem for patient. The study found problem squeaking was associated with only the Stryker Trident acetabular design used with their Accolade hip stem.
Based on the findings of this study, the authors recommend against using the Stryker Trident cup with the Accolade stem. More information on the study can be found at http://www.minitotalhip.com/
Dr. Todd Swanson conducted the study at his Las Vegas research facility with his fellows and medical students: Raghavendran Seethala, MS, David J. Peterson, PharmD, DO, Ryan Bliss, BBA, and Calvin Spellmon, BS.
