Despite extensive acetabular bone defects as found in revisions of total hip arthroplasty for high hip dislocation, the ilium usually still provides secure fixation of the pedestal of the acetabular component. Four cases are presented in which reconstruction was performed using a newly developed, conical, titanium, ribbed shaft socket designed for cementless press-fit into the dorsocranial ilium to obtain primary stability. In each case the pedestal cup allowed restoration of the original centre of rotation. There were no complications. A Harris hip score of 85 points was achieved after an average of 28.5 months. All components were radiologically stable. While the findings demonstrate the short-term efficacy of the procedure, longer follow-ups and a larger number of patients are needed before the durability of this reconstructive technique can be assessed.