One hundred and fifty-three so-called hybrid total hip replacements were performed in 142 patients from 1985 to 1987 at Rush-Presbyterian-St. Luke's Medical Center. A hemispherical porous-coated acetabular component was inserted without cement and was fixed with screws, and a femoral stem was inserted with the use of so-called third-generation cementing techniques. The average age of the patients at the time of the operation was sixty-seven years (range, thirty-nine to eighty-five years). The average preoperative Harris hip score was 46 points (range, 9 to 73 points). One hundred and eleven patients (120 hips) were available for clinical review; 100 of these patients (109 hips) had a complete set of radiographs available. The average Harris hip score was 86 points (range, 29 to 100 points) at the time of follow-up (average duration, sixty-two months; range, forty-eight to eighty-five months). There was progressive migration of one cup (1 per cent); another cup migrated one centimeter in the first two years after the operation, with no additional migration evident after that time. The remaining acetabular components were stable. Two femoral components (2 per cent) were determined to be definitely loose. The remaining femoral components were stable. This population of patients had a good result after so-called hybrid total hip replacement with insertion of a porous-coated acetabular component without cement and a femoral component with cement for the reconstruction of a painful hip.