High Hip Center Technique Using a Biconical Threaded Zweymüller® Cup in Osteoarthritis Secondary to Congenital Hip Disease

Abstract

Background The high hip center technique used for a deficient acetabulum is reconstruction of the hip at a high center of rotation. In the literature, there is no consensus regarding the value of this technique. Questions/purposes We investigated whether the new-generation biconical threaded Zweymüller^® cup fixed in a high nonanatomic position in patients with arthritis secondary to congenital hip disease experienced different rates of polyethylene wear and long-term survivorship when compared with anatomically positioned cups. Patients and Methods We studied the polyethylene wear rate and Kaplan-Meier survivorship of 104 titanium threaded Zweymüller^® cups in 88 patients (81 females), placed in 70 hips at near-normal hip center and in 34 hips at a high hip center position at a distance of 31.1 to 60 mm (mean, 39.7 mm) from the interteardrop line. Minimum followup was 2 years (mean ± SD, 8.6 ± 3.5 years; range, 2-15 years). Results The mean linear polyethylene wear rates in the near-normal and high hip center groups were not different (0.110 ± 0.050 mm and 0.113 ± 0.057 mm, respectively). The Kaplan-Meier 15-year cup survivorship rates with revision for any reason as an event of interest in the near-normal and high hip center groups also were not different (97.2% [95% confidence interval, 88.5%-99.3%] and 97.1% [95% confidence interval, 73.8%-99.3%], respectively). Conclusions The high hip center technique using a biconical threaded Zweymüller^® cup in patients with arthritis secondary to congenital hip disease results in a polyethylene wear rate and long-term cup survivorship comparable to those observed in anatomically positioned cups. Level of Evidence Level III, therapeutic study. See the Guidelines for Authors for a complete description of level of evidence.