Clinical Orthopaedics and Related Research®

, Volume 468, Issue 7, pp 1912–1919 | Cite as

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

  • Nikolaos A. ChristodoulouEmail author
  • Konstantinos P. Dialetis
  • Athanasios N. Christodoulou
Surgical Technique Hip



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.


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).


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).


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.


UHMWPE Deficient Acetabulum Interteardrop Line Polyethylene Wear Rate Metallic Head 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



We thank Ageliki Stavrianou, MD, Thomas Georgas, MD, Theodoros Papaioannou, PhD, Christos Sdrenias, MD, Georgios Salagiannis, MD, for help in preparing this manuscript.


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Copyright information

© The Association of Bone and Joint Surgeons® 2009

Authors and Affiliations

  • Nikolaos A. Christodoulou
    • 1
    Email author
  • Konstantinos P. Dialetis
    • 1
  • Athanasios N. Christodoulou
    • 2
  1. 1.Department of OrthopaedicsKarpenissi General HospitalKarpenissiGreece
  2. 2.Institut National des Sciences Appliquées de LyonLyonFrance

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