I was flummoxed to see charcoal black trochanter bursa and hip joint while performing the total hip replacement in a 53-year male patient 3 days ago. He had undergone both knee replacement and spine surgery few years ago as well.

Any suggestions regarding type of replacement—cemented/ uncemented, metal/ ceramic— in such patients and difficulties encountered, I chose to perform cemented ceramic joint. Abductor attachment was frail and bones severely osteoporotic.