Investigation of squeaking in pyrolytic carbon proximal interphalangeal joint implants

Caleb Davis, Andrew R. Thoreson, Lawrence Berglund, Steven L. Moran, Kai Nan An, Peter C. Amadio

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Article number014508
JournalJournal of Medical Devices, Transactions of the ASME
Issue number1
StatePublished - 2014


  • Finger
  • Joint replacement
  • PIP joint
  • Pyrolytic carbon

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Biomedical Engineering


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