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Background. In two-stage deep periprosthetic infection treatment, many authors describe mechanical complications associated with the implantation of a spacer in the first stage that affect the functional outcome of the treatment.Purpose. To evaluate the functional results of using 3D spacers for IIIA and IIIB defects according to the classification system described by W.G. Paprosky during the first stage treatment of hip deep periprosthetic joint infection (PJI).Methods. From 2017 to 2020, 24 patients underwent first-stage revision arthroplasty with hip PJI and IIIA and IIIB acetabular bone defects according to the classification system described by W.G. Paprosky. The patients were divided into 2 groups: group 1 received articulating spacers, and group 2 received custom-made spacers made using 3D technology. Function was evaluated by the Harris Hip Score, WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and VAS (visual analogue scale). Statistical analyses were performed using IBM SPSS Statistics version 22.0 for Windows. Student's t-test, Wilcoxon's signed-rank test (to compare parameters before and after surgery) and the Mann-Whitney rank-sum test were used.Results. In the first group, the average VAS score was 3.3 (± 1.4), the Harris Hip Score was 51.3 (± 9.4), and the WOMAC score was 42.9 (± 5.9); in the second group, the VAS score was 1.3 (± 0.9), the Harris Hip Score was 69.7 (± 3.6), and the WOMAC score was 30.1 (± 2.4). The rating scale data showed a statistically significant improvement in the function of patients in the second group (p <0.05).Conclusion. Custom-made 3D spacers used during the first stage of treatment for deep periprosthetic hip infection yield larger improvements in function and quality of life than do articulating spacers.Trial registration. Local Ethics Committee at the Sechenov First Moscow State Medical University Ministry of Health of Russia (Sechenov University) № 386 13.12.2016.