Birmingham Hip

[ELIZABETH]

This is Elizabeth.  I had the Birmingham Hip replacement in April 2007.  At times I have a squeaking noise from the new joint that can be heard outside of my body and I still have pain. Anyone else experienced the same?  Elizabeth

[Pat Walter]

Hello Elizabeth

Squeaking noises are not uncommon. Here is an excerpt from Dr. De Smet's Website:

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53. What are squeaking noises?
ALL ABOUT SQUEAKING NOISES. (seeing and hearing...? Click here)
Also called peeping, called by Dr.De Smet the “peepcreep”. The squeaking noises are produced due to a temporary lack of lubrication, a dry running of the metal-on-metal prosthesis. . It sounds as a non-lubricated creaking hinge of a door. The duration of the noise is normally less then 24 hours, and a one-time incidence.
It starts when the patient has an increase or change in activities. Stair climbing always generates or increases the noise. (Possible provoking activities: mountain climbing, mountain walking, chopping wood,…)
It does not occur any more 2 years after surgery. Two year is the time interval that equals the running in period of a metal-on-metal friction couple. Running in means that the prosthesis is polishing itself. Immediately after surgery, the lubricant (lubrication film) between the 2 components of the prosthesis is blood. This will change to serum with our own proteins after a while. The percentage of patients where squeaking noises appear is about 1.5%.

It is a benign incident that goes away spontaneously and do not need any panic. (let it know to your surgeon for statistical reasons!).
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I never had squeeking, but one lady wrote that she went to go up or down the stairs when she was doing her laundry and the squeek was so loud that her husband yelled back - I will fix the belt in the dryer in a couple minutes! He thought it was the dryer making the noise.  It only happened really loud once for her.

There are also clunks.  That is more of a feeling inside. I have had cluncks since right after my surgery.  Most of that is due to loose muscles.  The muscles have to get back into shape after surgery and in my case, lack of use for many years.

Here is his info about cluncking
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54. What is clicking, clocking or clunking?
The clunking noises and clicking feeling in the first 6 months after surgery is a temporary decoaptation of both components. This means that the two big metal parts of the prosthesis come apart and come together again. Having a large diameter this gives no wear of the prosthesis and will not destroy anything. Because of the release of the capsule around the hip to be able to do a resurfacing procedure without sawing the head of, the hip joint is looser at the beginning. This is even more because of the badly trained muscles of the preoperative condition and all the fluid around the newly placed joint.
The clunking is painless and subsides once the capsule and muscles around the hip are fully healed. It occurs in the first 6 months after surgery and disappears progressively.
The incidence can be around 20% of all patients!

This finding should not be confused with local conflict problems with prosthesis or bone because of less ideal inserted implants. These will stay even after 6 months, will not become better, is painful and should be diagnosed by your physician.

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About the pain - have you or are you taking physical therapy?  I am not a doctor, but from reading about hundreds of people's hip resurfacings, pain is usually from the muscles around the new hip.  I never had pain after surgery, but at about 3 months post op I would get so stiff after sitting that my first few steps would really hurt.  Then I would be ok once I got moving.  I started taking pool therapy. Did water walking, stretches and exercises. That took away the stiffness and my muscles never hurt after that.

You might want to talk with your doctor about the pain and what he/she suggests.  You might need more stretches or exercises to get your muscles back into shape.  If you had a bad hip for a long time, the muscles got use to not working right due to limping and inactivity.  If you had a serious problem and need your leg lengthened, etc, you will have muscles problems for a much longer time since they have to get use to the new leg length or position.

I hope that helps some. 

Pat in Ohio
3/15/06 LBHR De Smet