FP12.4 Impact of Squeaking on Substantial Clinical Benefit After Total Hip Arthroplasty: A Ten-Year Follow-up

Abstract ICLA12 - The Chondral Masterclass: Advanced Scaffolds, Orthobiologic Realities, and Young THA, Auditorium B (BMCC Level 1), October 9, 2026, 10:30 - 12:30 Objectives To analyze whether the phenomenon of squeaking following ceramic-on-ceramic (CoC) total hip arthroplasty (THA) affects long-term clinical outcomes, by evaluating the achievement of the Minimal Clinically Important Difference (MCID) and Substantial Clinical Benefit (SCB). Materials and Methods A retrospective study was conducted including 68 patients (40 men, 28 women; mean age 49.5 years; mean BMI 24.58) with a mean follow-up of 11.45 years (range 10–14). All patients underwent CoC THA using the same stem and acetabular component design, with femoral head sizes of 36 mm (n=53) and 32 mm (n=15). Functional outcomes were assessed using the iHOT-33 and HOS (Activities of Daily Living and Sports subscales). Comparative analysis between cohorts with and without squeaking was performed using Fisher’s exact test for categorical variables (MCID/SCB) and Student’s t-test for continuous variables, with statistical significance set at p<0.05. Results Squeaking occurred in 23 patients (33.8%), being mostly episodic and associated with extreme ranges of motion. No infections or revision surgeries were recorded. At 10 years, the clinical success rate (MCID) exceeded 90% for both iHOT-33 and HOS-ADL in the overall cohort. No statistically significant differences were observed in SCB achievement at 10 years between patients with and without squeaking: iHOT-33 (SCB): 83% vs 86% (p=0.74) HOS-ADL (SCB): 83% vs 86% (p=0.74) HOS-Sports (SCB): 50% vs 60% (p=0.44) One patient requested information regarding revision due to acoustic discomfort but ultimately declined given excellent functional outcomes. Overall satisfaction remained high, with no correlation between noise and implant failure. Conclusions At 11-year follow-up, squeaking in CoC THA does not compromise functional outcomes or the achievement of substantial clinical benefit. It represents an activity-dependent mechanical phenomenon that does not predict bearing failure. Surgeons can reassure patients that implant survival and clinical success are independent of the presence of this acoustic phenomenon.