A retrospective outcomes study was performed on 25 consecutive acetabular reconstructions of major segmental defects by using an oblong-shaped cementless implant. All patients had combined acetabular defects (type III) as defined by the American Academy of Orthopaedic Surgeons classification of acetabular bone deficiency. Long-term follow-up was performed at an average of 11 years postoperatively. Clinical and radiographic outcomes were measured. Failures were defined by component revision or clear radiographic evidence of loosening. Six patients died before final evaluation, and 4 patients did not have complete radiographic data, leaving 14 patients (15 hips) for final analysis. At final follow-up, only 3 of the implants had failed and were revised. There was 1 case of a well-functioning implant with circumferential radiolucency; otherwise, there was no evidence of loosening among the remaining implants.