Abstract
A 76-year-old woman with fibrous dysplasia (FD) of the femur presented with severe deformity and secondary osteoarthritis. Total hip arthroplasty (THA) was performed using a cemented stem without femoral osteotomy, following thorough 3D preoperative planning. No intraoperative complications occurred. At the three-year follow-up, gait had significantly improved, and no loosening or fracture was observed. Cemented THA without osteotomy is a viable and less invasive option for elderly patients with FD-associated femoral deformity. This approach offers favorable implant positioning and minimizes the risk of intraoperative fracture.