Chief Complaint: 67 -year-old male, Left hip pain persisting for 20 years, becoming progressive over the last 2 years, accompanied by a significant limp. ​History: A history of untreated/undiagnosed hip disorder during childhood (consistent with late-stage Perthes sequelae). ​Physical Examination: 2 cm shortening of the left lower extremity, positive Trendelenburg sign, and severe restriction in the range of motion (ROM) in all directions. Radiological Findings: Fig 1: