One commonly reported complication of pyrolytic carbon arthroplasty at the proximal interphalangeal (PIP) joint is an annoying, painless, squeaking postoperatively. This squeak has been anecdotally associated with implant loosening or impending dislocation. The purpose of this study was to investigate the etiology of this squeaking. Proximal and distal components of the pyrolytic carbon PIP implant were inserted into foam bones and mounted onto an oscillating test device. We evaluated the effect of 96 combinations of load, velocity, contact angle, implant size, lubrication, and displacement amplitude over a total of 300 cycles for each condition. Sound analysis was performed on squeaking conditions. Fourteen conditions resulted in squeaking, all with a sound pattern similar to that noted clinically. Unlubricated, “dry” joints did not squeak. Squeaking most commonly occurred with fetal bovine serum lubrication, at higher loads, and at 0 deg hyperextension. Hyaluronic acid viscosupplementation stopped the squeaking in all cases.

References

References
1.
Cook
,
S. D.
,
Beckenbaugh
,
R. D.
,
Redondo
,
J.
,
Popich
,
L. S.
,
Klawitter
,
J. J.
, and
Linscheid
,
R. L.
,
1999
, “
Long-Term Follow-up of Pyrolytic Carbon Metacarpophalangeal Implants
,”
J. Bone Joint Surg. Am.
,
81
(
5
), pp.
635
648
.
2.
Meier
,
R.
,
Schulz
,
M.
,
Krimmer
,
H.
,
Stutz
,
N.
, and
Lanz
,
U.
,
2007
, “
Proximal Interphalangeal Joint Replacement With Pyrolytic Carbon Prostheses
,”
Oper. Orthop. Traumatol.
,
19
(
1
), pp.
1
15
.10.1007/s00064-007-1192-8
3.
Tuttle
,
H. G.
, and
Stern
,
P. J.
,
2006
, “
Pyrolytic Carbon Proximal Interphalangeal Joint Resurfacing Arthroplasty
,”
J. Hand Surg.
,
31
(
6
), pp.
930
939
.10.1016/j.jhsa.2006.02.018
4.
Bravo
,
C. J.
,
Rizzo
,
M.
,
Hormel
,
K. B.
, and
Beckenbaugh
,
R. D.
,
2007
, “
Pyrolytic Carbon Proximal Interphalangeal Joint Arthroplasty: Results With Minimum Two-Year Follow-up Evaluation
,”
J. Hand Surg.
,
32
(
1
), pp.
1
11
.10.1016/j.jhsa.2006.10.017
5.
Chung
,
K. C.
,
Ram
,
A. N.
, and
Shauver
,
M. J.
,
2009
, “
Outcomes of Pyrolytic Carbon Arthroplasty for the Proximal Interphalangeal Joint
,”
Plast. Reconstr. Surg.
,
123
(
5
), pp.
1521
1532
.10.1097/PRS.0b013e3181a2059b
6.
Chevillotte
,
C.
,
Trousdale
,
R. T.
,
Chen
,
Q.
,
Guyen
,
O.
, and
An
,
K. N.
,
2010
, “
The 2009 Frank Stinchfield Award: ‘Hip Squeaking’: A Biomechanical Study of Ceramic-On-Ceramic Bearing Surfaces
,”
Clin. Orthop. Relat. Res.
,
468
(
2
), pp.
345
350
.10.1007/s11999-009-0911-x
7.
Moran
,
J. M.
,
Hemann
,
J. H.
, and
Greenwald
,
A. S.
,
1985
, “
Finger Joint Contact Areas and Pressures
,”
J. Orthop. Res.
,
3
(
1
), pp.
49
55
.10.1002/jor.1100030106
8.
Weiss
,
C.
,
Gdaniec
,
P.
,
Hoffmann
,
N. P.
,
Hothan
,
A.
,
Huber
,
G.
, and
Morlock
,
M. M.
,
2010
, “
Squeak in Hip Endoprosthesis Systems: An Experimental Study and a Numerical Technique to Analyze Design Variants
,”
Med. Eng. Phys.
,
32
(
6
), pp.
604
609
.10.1016/j.medengphy.2010.02.006
9.
Ibrahim
,
R. A.
,
1994
, “
Friction-Induced Vibration, Chatter, Squeal, and Chaos Part Ii: Dynamics and Modeling
,”
Appl. Mech. Rev.
,
47
(
7
), pp.
227
253
.10.1115/1.3111080
10.
Sweets
,
T. M.
, and
Stern
,
P. J.
,
2011
, “
Pyrolytic Carbon Resurfacing Arthroplasty for Osteoarthritis of the Proximal Interphalangeal Joint of the Finger
,”
J. Bone Joint Surg. Am.
,
93
(
15
), pp.
1417
1425
.10.2106/JBJS.J.00832
11.
Haase
,
S. C.
, and
Chung
,
K. C.
,
2013
, “
‘Clinical and Radiographic Outcomes of Metacarpophalangeal Joint Pyrolytic Carbon Arthroplasty for Osteoarthritis
,”
J. Hand Surg.
,
38
(
3
), p.
544
.10.1016/j.jhsa.2012.11.025
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