OBJECTIVES: Total hip arthroplasty (THA) is a common, cost-effective operation for patients suffering from coxarthritis. Unfortunately, revisions are relatively frequent and their incidence is correlated to the size of the acetabular defect. The aim of this study is to analyse the cost-effectiveness of a new type of porous three-flanged implant (PTFI) targeting revision surgery of Paprosky type IIIB acetabular defects compared to the most common alternative for these serious acetabular defect, being a (non-porous) Custom Three-flanged Acetabular Component (CTAC). METHODS: CTAC were compared to the new PTFI by means of a Markov model with four states (successful, re-revision, resection and dead). The cycle length was set at 6 months with a 10 year time horizon. Implant survival, transition probabilities and quality of life measures were obtained through systematic literature search and data obtained from the manufacturers. Costs from the health care payer’s perspective were calculated based on data from the literature, obtained from manufacturers and from social security agencies. Discount rates were used on cost (3%) and QALY (1.5%) estimates. RESULTS: Based on the outcomes of our model, the new PTFI provides good value for money. For the basecase of a 65 year old man, a QALY gain of 0.296 and cost reduction of 390€ is obtained. In all age and gender groups the use of the new PTFI is dominant. The price of the implant has the highest impact on cost side while the utility for successful surgery has the biggest influence on the QALY. Probabilistic analysis resulted in 33.4% of the cases being dominant. CONCLUSIONS:  Based on the findings of this model, the new PTFI has the potential to provide excellent value for money when used in revision athroplasty of Paproski type 3B acetabular defects. This was mainly due to lower revision and complication rates.