The use of a high-hip center in revision total hip arthroplasty

In certain cases, primary and revision total hip arthroplasty is complicated by insufficient bone stock and distorted acetabular anatomy such that the craniocaudal dimension of the acetabular recess is greater than the anteroposterior dimension. Acetabular reconstruction in such cases can be carried out by placing the acetabular component more proximally than normal (high-hip center). Recent biomechanical and clinical data suggest that placement of the acetabular component at a higher than normal hip center does not adversely effect the longevity of the component fixation. Proximal placement of the hip center also facilitates the contact between the host bone and the porous coating when uncemented porous coated components are used, and minimizes the need for structural bone grafts. However, femoral components with longer neck lengths and removal of impinging bone are needed when the acetabular components are placed more proximally in order to restore the limb lengths and minimize the chances for dislocation.