CASE: We present a 51-year-old woman with Aitken A proximal femoral focal deficiency (PFFD) managed with total hip arthroplasty (THA). This patient presented with a history of disabling hip arthritis and multiple operations to improve her proximal femoral deformity and maintain a reduced hip. The hip was dysplastic with persistent femoral deformity, erosive acetabular changes, and abductor weakness. The surgical treatment was a THA. CONCLUSION: In the setting of hip arthritis, despite abductor weakness and deformity of the proximal femur, hip arthroplasty is a viable option for management of the patient with Aitken A PFFD.
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