Pre-operative AP X-Ray pelvis with both hip joints (Case 1) showing grade IV OA both hip joints and one year follow-up post-operative X-ray after bilateral uncemented bikini hip replacement showing well aligned acetabular and femoral prosthesis in situ. (Case 1). During surgery the stem was prepared first followed by the cup. Prosthesis details: Acetabular shell: R3 three hole HA acetabular shell (Smith and Nephew Memphis Tennessee). Acetabular liner: R3 XLPE (Smith and Nephew). PolarStem femoral stem (uncemented − Smith and Nephew AG, Baar, Switzerland), femoral head: oxinium femoral head (Smith and Nephew Memphis Tennessee). The total operative time was 2 h and 15 min.