Hip arthroplasty is an excellent option for multiply operated non union of the proximal Femur.
Instead of prolonging the long disability of patient with chronic non union (esp. in older patients) - correctly done hip replacement will give an immediate result and patients are delighted with the same. Further the non union almost always goes into solid union due to the load bypass.
In patients with multiple bone secondaries - fracture fixation with a long wait for bone to unite is not justified. It is much better option to do a hip replacement so that the patient can ambulate immediately. The example shows a patient with multiple skeletal secondaries due to breast cancer and a pathological fracture. Patient is able to walk the day after surgery without any weight bearing restrictions.
Upper femur deformities will require modular stem and extensive planning to get everything right in THR.
Hip arthroplasty can be done without further cutting the bone (osteotomy) in most instances.