Between 1987 and 1991, 20 large proximal femoral replacements were performed in 19 patients (10 males and 9 females). The median age was 60 years (15 to 89 years). Four patients presented with a primary sarcoma involving the proximal femur; 15 had bone destruction secondary to metastatic disease. Twelve of the 20 had a pathological bone fracture. The average length of the proximal femoral resection was 12 cm (7 to 26 cm). Fourteen patients could be evaluated for pain and function according to the SICOT hip-evaluation score. All patients, except one with rapidly progressing local disease, were able to walk again independently using one or two crutches. Limping and a positive Trendelenburg sign were observed in all cases but two.