AbstractSection Purpose

The impact of noise on the outcomes of fourth-generation ceramic-on-ceramic (COC) revision hips remains unclear. This retrospective study aimed to evaluate long-term outcomes in fourth-generation COC revisions, assessing: (1) the rate, type, and frequency of noise and its impact on patient satisfaction, and (2) demographic, implant-related, and radiographic factors associated with noise generation.

AbstractSection Methods

A retrospective analysis was conducted on 63 patients with fourth-generation COC revisions. Clinical and radiographic data were collected. A non-validated phone questionnaire was administered to assess incidence, type, and impact of noise on daily life and patient satisfaction.

AbstractSection Results

At a mean follow-up of 11.34 ± 2.45 years, the mean Harris hip score was 85.34 ± 11.48 points. No re-revisions were performed. Noise was reported in 32% of all the patients, half of them reporting squeaking. Patients were satisfied with the procedure regardless of noise (80% with squeaking, 90% with other noises, 88.4% with silent hips) (p = 0.42). Over 75% of patients reported being unaware of the implant when sitting, regardless noise occurrence (p = 0.59). Most patients with squeaking (80%) did not experience pain (p = 0.22). Noise had no impact on daily life in 60% of squeaking and 90% of other noise cases (p = 0.3). Younger age, higher acetabular offset and lower cup inclination were found to predict the onset of noise.

AbstractSection Conclusion

Noise occurrence in fourth-generation COC revisions was up to 30% at long-term, squeaking accounting for half of the cases. However, noise did not impact the outcomes. Age, acetabular offset and cup inclination were identified as predictive factors of noise.