We report results using the hydroxyapatite coated, distally locking Cannulok revision hip prosthesis. The component was used to treat periprosthetic and pathological fractures, often in the presence of aseptic loosening or infection in a group of elderly patients. 16 patients with a mean age of 78 years underwent surgery by a single surgeon over a period of 3 years. They were followed up clinically and radiologically for an average of 24 months. The mean modified Merle D’Aubigne and Oxford Hip Scores were 14 and 23.6 respectively. These results are comparable to the published results for the previous version of the Cannulok hip, and other revision hip revision series. We believe the implant provides a relatively simple and effective reconstructive option that can be used as an alternative to more extensive surgical options in elderly patients with periprosthetic fractures.