Cause of clunking noise in total hip replacement : LUSENET : About Joints : One Thread

I am a 43 year old female with bilateral hip replacements for coxa vara (congenital dysplasia). I had my right hip replaced November 2002 and my left hip replaced April 2003. Both surgeries were great- no pain, no complications; however, due to the poor pre-operative condition of my abductor muscles, I still have a pronounced Trendelenberg gait despite intensive physiotherapy and pool therapy and I still walk with a cane. I have recently employed a personal trainer who specializes in Pilates and I have made a tremendous improvement in just a few weeks in my gait. The problem I have is with a persistent clicking/ clunking noise in my weaker right hip when I shift position of my pelvis (side to side, or front to back). My surgeon and a sales associate for a prosthetic company both deny ever hearing anyone complain about this problem before. It feels like the liner of the acetabulum has come loose(?) I have only a little posterior gluteal pain associated with the area where the sound and movement is coming from, but this could just be from intensive gluteal exercises. Has anyone else ever experienced this sound/feeling in their replacement hip?

-- christina delottinville (, October 13, 2003


I have exactly the same problem with the clunking noise in my right hip when I shift position of my pelvis. My left hip was done in 1999 and doesn't do this - it is conventional metal and plastic. My right hip was replaced in July this year with a ceramic-on-ceramic device. The sensation is of the liner coming loose, or a tendon that is going over-center. I do not have an answer, have you received one? I go back to the Surgeon in 2 weeks for a check-up. GM

-- GLEN MCDOUGALL (, November 14, 2003.

Ironically, I am a 46 y/o male who had a hip replacement on 12/9/2003, with instruction of partial weight bearing for the first 4 weeks. Today, just started to do some addititional weight bearing and am noticing a similar sound. It's got me curious if you guys ever found an answer. I have read only that the clicking sound means it's wearing out, but the looseness from limited activity and muscle stretching sounds like a viable answer as well.

-- Stan Dombrowksi (, January 04, 2004.

Hi Stan,

I have been in touch with Glenn about the clunking and movement in the hip prosthesis and his surgeon believes it is related to the prosthesis parts pivoting against each other during certain movements. My ongoing and extensive investigation is leading me in the direction of muscle and ligament imbalances which are pulling the new hip out of proper alignment. If you have the interest and some type of medical background, a good book to read (which includes physiotherapy exercises) is "Movement Impairment Syndromes" by Dr.Shirley A. Sahrmann. I have found it to be the perfect reference to movement disorders caused by muscle and bone and joint imbalances. She also is a physiotherapist and the book includes illustrated exercises to correct the imbalances. You can buy this book at any online book selling company (I.e. Amazon or Chapters)

My own physiotherapists are stressing building up the gluteus maximus and abdominal and back muscles in my treatment. Along this line, I am mostly using Pilates and a treadmill and elliptical trainer to accomplish this, as well as pool therapy and weight training. My situation is very different from a straight replacement since I was born with hips which were misaligned and consequently my body is trying to adjust to the new position and an added one inch on one side, and two inches on the other!

I would suggest that you do not try to overdo the rehab on your new hip until it has had time to knit the bone onto the prosthesis (if uncemented) and to allow the joint capsule to regrow around the joint. Do not use weights or pulley-type weight machines for at least 6 months post-op. I use the Pilates reformer machine at home and at physiotherapy, as well as tension bands, stabiliser ball, balance board, treadmill, elliptical trainer and the pool ( and anything else I can rig up to speed up the process). It is hard not to get discouraged at times, but don't give up and you'll be amazed how far you will come in a short time. It helps to keep a hip diary so that you can chart your progress- small things like giving up a walker and standing on one leg- will be major milestones in your recovery.

My hips still move and clunk but less so if I squeeze my buttocks and lower abdominal muscles to stabilize the pelvis. My surgeon is not sure why this is occurring, so I have taken it upon myself to discover the cause. If you find anything to support this or any other explanation, please share it with Glenn and I.

Happy Healing, Christina deLottinville

-- Christina deLottinville (, January 05, 2004.

I was doing a search about "clicking after a hip replacement" and this site came up. I am 35 years old and had a THR on my right hip after years of Legg-Perthes Disease and the resulting arthritis. Lately, I have noticed that same clicking sound that everyone has been talking about. I am nervous b/c I dont want my hip to be loosening. I appreciate the last share in January of this year. Amanda

-- Amanda Garrigues (, March 04, 2004.

Hi all,

I don't know if I have the same thing everyone else is talking about, but ever since my THR (R) my hip just seems to pop and crack like it's going in and out of joint . If I stand by a counter and rest all of my weight onto my left leg it feels like my right leg is just hanging there out of socket and using my buttocks and muscles I can just move it around and it's like it pops in and out. Is this the same thing you're having? It also happens when I'm sitting down and make a wrong move. I can make it happen by just relaxing my leg and moving it around. I've always wondered if this was standard operating procedure after a hip replacement or should it feel like my normal hip? I also had the same thing before my hip replacement with severe groin pain which I also still have. My whole story is posted somewhere here are under groin pain so I won't go into the details here. Any answers would be greatly appreciated. Thanks to all who post here. It's nice to know I'm not in this alone. BTW my THR was done in 2000.

-- Sue Shields (, July 15, 2004.

Hi Sue,

The noises and movement in your prosthesis are due to looseness of the muscles and ligaments around the prosthesis and may not disappear entirely, even with lots of rehab. The important thing to remember is not to step outside the range of motion of the new hip- keep your foot and knee pointing in the same direction as your body, or else you can easily "pop" the hip out of the prosthetic acetabulum. The new hip is wonderful but it still is not as moveable as a normal "real" hip would be.

As for the groin pain, I had a persistent pulling ache in my groin after my second hip replacement and this was alleviated through fascial release of scar tissue by a massage therapist (a few visits and I was good as new).

I have had two replacement surgeries and one hip pops, squeaks and moves, while the second one only pops when I abduct to its furthest range.

My surgeon tells me not to try to make it pop, but it's like cracking a knuckle-once it pops, I can move it better during exercising.

It's all trial and error- I figure that if the joints let me do an activity (even the so-called no-no's, I'll try it). After years of living in pain with limited range of motion, I feel empowered to try things I could never conceive of doing before (within reason).

Good Luck with your new improved hip!

-- christina delottinville (, July 15, 2004.

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