An 8-year 8-month followup of a now 78-year-old active woman with a painful, severe varus deformity of the femur and arthritis of the right hip associated with monostotic Paget's disease of the hip is presented. Treatment consisted of multiple osteotomies, followed by implantation of a long stemmed cobalt chrome fully coated porous ingrowth hip system. The patient had an excellent outcome, including relief of pain and restoration of excellent function, despite ongoing severe osteolytic changes that did not appear to influence the healing of the osteotomies or the clinical stability of the implant.