A 71 year old Caucasian lady of British origin, presented with aseptic loosening of left charnley total hip replacement, performed 20 years ago (). Radiography revealed acetabular bone stock deficiency in the superolateral and inferior quadrants. She underwent Left revision total hip replacement with a Birmingham resurfacing dysplasia cup (HA coated size 52 mm) and femoral bone allograft in superolateral compartment, Echelon revision collared stem (190 mm) and calcar substitute, with head size measuring 42 mm. Acetabular cup was anchored with 2 suprolateral screws. Postoperative recovery was uneventful. Initial postoperative X-ray () showed a minimal interference gap between the acetabular cup and bone. Cup and screw positions were satisfactory. Initial mobilisation was with 2 elbow crutches for 6 weeks, 1 elbow crutch for another 6 weeks and finally onto 1 stick. Patient’s recovery was satisfactory at 6 weeks, 3 and 6 months follow up. At 8 months follow up she complained of worsening left hip pain especially with mobilisation. X-ray () confirmed broken acetabular screws with minimal migration of cup. Sepsis was ruled out after thorough clinical, radiological, biochemical and microbiological investigations. At 12 months there was a progressive posterior inferior migration of acetabular cup (, ).