Management of type III acetabular deficiencies in revision total hip arthroplasty without structural bone graft

Seventeen patients with loose total hip acetabular components and type III osteolytic acetabular defects were prospectively identified and reconstructed with either spherical acetabular components or eccentric acetabular components without use of structural bone graft. A computed tomography (CT) scan and a three-dimensional (3-D) model were obtained in nine patients to determine whether a spherical component or eccentric component should be used. The clinical results were measured using the Harris Hip Score. Hip scores improved from 44 to 73 points for the entire group but were lower in the subgroup with eccentric components. Also, two of the eccentric cups developed loosening. The hip center was better restored in the eccentric implant group. The cost of the prosthesis was higher in the eccentric implant group due to the expenses of the CT scan and the 3-D model.