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Bone mineral density of the proximal femur was measured in six patients who underwent hemisurface replacement for osteonecrosis of the femoral head. Bone mineral density values in operated and contralateral nonoperated hips were compared. In four patients who had sequential examinations, bone mineral density was compared over time. Average patient age was 34.6 years, average follow-up was 9.1 years, and mean follow-up of bone mineral density measurements was 6.6 years. Average bone mineral density variation was 0.0048 to −0.0264 g/cm2 per year in all five regions in nonoperated hips and −0.012 to −0.0300 g/cm2 in operated hips. These results support bone conservation and preservation with hemiresurfacing arthroplasty in young patients with osteonecrosis of the femoral head.