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 newgeneration biconical threaded Zweymüller 1 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 1 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). ResultsThe 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