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We reviewed our experience with total hip replacement for coxarthrosis due to Paget's disease. The clinical and radiographic results in twenty-one patients who had a total hip replacement between October 1972 and February 1982 were analyzed. The ages of the patients averaged 68.6 years (range, fifty-seven to eighty years) and there were twelve women and nine men. The follow-up averaged five years and two months (range, two years to eleven years and four months). A good or excellent result was achieved in eighteen patients. Of the other three patients, two required a revision operation at two and one-half and five years postoperatively for symptomatic mechanical loosening of the femoral component. The remaining patient had a fair result because of activity of the Paget's disease. Special problems that we encountered included varus deformity of the proximal end of the femur predisposing to varus placement of the femoral component, protrusio acetabuli, increased blood loss, sclerotic bone that made reaming difficult, and heterotopic ossification.