In young patients, the results of cemented hip joint replacement are less than satisfactory on account of the high rate of aseptic loosening involving in particular the acetabular component. With the aid of suitable uncemented prostheses and a meticulous surgical technique, the results obtained in this group can be improved. On an interim basis, an uncemented acetabular component may be combined with a cemented femoral component. The problem of wear and foreign body-induced bone resorption remains unsolved. New materials will possibly rectify this problem. Customized prostheses have opened up new possibilities, in particular for the severely deformed hip joint, but whether they will improve the results of standard replacements has yet to be shown. Before introducing a new prosthesis, thorough use should be made of the testing possibilities available. In the elderly patient with a reduced life expectancy, the cemented prostheses continue to be the method of first choice, since it permits immediate pain-free weight-bearing.