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Purpose of this study was to evaluate the outcomes of patients underwent hemiarthroplasty for proximal femoral fracture converted to total hip arthroplasty (THA).A total of 138 patients from October 2009 till October 2014 had conversion of their failed hemiarthroplasties following a proximal femoral fracture to total hip arthroplasty (THA) in Erfan and Milad hospitals, Tehran. We performed a prospective analysis of the outcome of conversion surgery in patients with failed hemiarthroplasty. The patients had clinical evaluations at 1 month, 6 months, 1 year, and annually thereafter. We used Harris Hip Score (HHS) to evaluate the results of conversion procedure in terms of relief of groin pain and functional improvement.Dislocation occurred in 6 patients (4.34%). The mean period of follow-up was 42 months (range 36–60 months). HHS score improved from mean preoperative score of 44.93 ± 8.40 to 95.41 ± 2.27 at final follow-up. The survivorship analysis with revision of HHS score was 89.1%. Existence of infection (P = .038) and time of primary operation to being symptomatic (P = .009) can predict the postoperative pain significantly.THA is a safe option which can lead to good functional and short-term and mid-term outcomes; and patients should be informed of the possibility of incomplete relief of groin pain or other symptoms postoperatively.