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Total hip arthroplasty with a special segmental replacement of the proximal end of the femur which varied in length from eighty to 150 millimeters was performed in twenty-one patients who had severe non-neoplastic conditions of the proximal part of the femur that necessitated salvage. Ten patients had previously failed arthroplasties associated with loss of bone structure; seven had non-union of a proximal femoral fracture or osteotomy associated with severe hip disease; there had a failed resection arthroplasty; and one had an arthrodesis and incapacitating low-back pain. Clinical and roentgenographic data during follow-up of twenty-five to ninety-two months showed that only one patient had loosening of the acetabular component. In twenty of the twenty-one patients, total hip arthroplasty with proximal femoral replacement was effective in restoring the integrity of the bone and restoring function of the hip.