Management of the infected hip replacement associated with substantial loss of bone, especially segmental loss of the proximal femur, is a challenging problem. In this report, the authors outline the development of an immediate-fit, custom-made, antibiotic-selective replacement system for the hip and proximal femur, to help maintain limb length, joint stability, and mobility of the patient. Despite the initial relatively crude design, it was a valuable adjunct in the management of 15 consecutive cases. A more sophisticated and versatile system has since been developed for use in straightforward and complex cases.