To investigate the method and efficacy of acetabular bone defect reconstruction in revision surgery after total hip arthroplasty (THA). A retrospective analysis was performed on 81 patients (84 hips) with acetabular bone defects treated during THA revision, 7 hips of type I, 56 hips of type II, 17 hips of type III, and 4 hips of type IV according to the AAOS staging method. Patients with different types of bone defects were repaired using large diameter non-cemented prosthetic socket, non-cemented prosthetic socket + cancellous granular implant, cemented prosthetic socket + Cage + cancellous granular implant and cemented prosthetic socket + custom type prosthesis + cancellous granular implant, respectively. Regular postoperative follow-up was performed to assess the function of the hip joint using the Harris method and to determine whether there was loosening of the prosthesis and healing of the grafted bone based on radiographs. The patients in this group were followed up postoperatively for an average of 45 months (13 to 118 months). The mean postoperative Harris score was 86.2, with a mean improvement of 40.6 points compared with the preoperative score. 2 hips required revision due to dislocation, but the rest had good results, with no loosening and sinking of the prosthesis on radiographs, and continuity of trabecular bone passing through the graft-host bone junction. In THA revision, most acetabular bone defects can be repaired with larger non-cemented prostheses or with cancellous granular implants; for larger defects that affect the stability of the prosthesis, good results can be obtained with cemented prosthetic socket + Cage + cancellous granular implants; custom-made prostheses have unique advantages in the management of severe acetabular bone defects.