The incidence of squeaking in hip replacement varies for ceramic-on-ceramicand metal-on-metal bearings, and the implications are not fully understood.Contributing factors may include component malposition, edge loading, impingement,third-body particles, and loss of lubrication. However, squeaking is multifactorial,requiring a certain combination of interaction among patient, surgical, andimplant factors. When squeaking is infrequent and function is not impaired,patients should avoid activities that precipitate the squeaking. Surgery isrecommended for persistent or troublesome squeaking, severe malpositioningof components, failure of the implants (including fracture), impingement andsubluxation, and pain. If necessary, the bearing can be changed during surgeryto another ceramic-on-ceramic or to a ceramic-on-polyethylene bearing.