Abstract: Between 1997 to 200, 230 patients underwent primary cemented total hip replacement using the ULTIMA Cobalt alloy, collarless femoral stem and UHMW Polyethylene Cup.184 Patients were available for review with an average follow up of 48 months. The average age at operation was 69 years. The majority of the patients were female (58%). Most of the surgeries were performed by a Consultant Surgeon(91%). Cementing technique was satisfactory in majority with a cement mantle of Grade B noted in 81% of the patients. The position of the femoral stem was noted to be in neutral position in the majority of the patients (76%) with varus and valgus positions in 21 % and 3 % respectively. There was radiological evidence of loosening in 39% of the patients at the follow up out of which a quarter of patients were symptomatic clinically. Subsidence of the femoral stem was noted in 30% of the patients out of which majority 71% had evidence of loosening. About 8 patients had undergone revision or waiting revision surgery. Revision surgeries were performed between 3 to 7 years following the primary surgery with a peak in the 5^th year