A retrospective review was undertaken of thirty-seven hips (thirty-four
patients) that had had a complex cemented total hip arthroplasty. In these
hips, circumstances had necessitated that the center of the hip be placed
farther proximally, as measured from the interteardrop line, than the
anatomical position that is normally used. The mean duration of clinical
and roentgenographic follow-up was eleven years (range, seven to seventeen
years), and the mean age of the patients was fifty-one years (range,
sixteen to seventy-three years). Most of these hips had a major deficiency
or defect of the acetabular bone stock, or both. Of the six acetabular
components (16 per cent) that became loose and were followed for ten years,
only one needed revision. Because this study was aimed specifically at
assessment of the acetabular component, if the femoral component alone
needed revision, the final clinical rating that was used was the one
obtained after the femoral revision. Thirty-one hips (84 per cent) were
rated as having a good or excellent result; they had an average Harris
hip-rating score of 43 points preoperatively and 93 points postoperatively.
Thirty-three of the thirty-seven acetabular components were not
substantially displaced laterally as compared with the anatomical location
that is normally used. Our findings suggest that, when circumstances
dictate, proximal positioning of the acetabular component without lateral
displacement can give an acceptable result in cemented total
hip-replacement procedures.