Management of Type III Acetabular Deficiencies in Revision Total Hip Arthroplasty Without Structural Bone Graft

ABSTRACT: 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 threedimensional (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  as 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.