Total hip arthroplasty in patients with inflammatory arthritis is compromised by the young age of patients at presentation, intake of non-steroidal anti-inflammatory drugs, steroid use and autoimmune diseases which negatively affect bone quality. This study evaluates the survival of total hip arthroplasties (THA) in 32 patients with inflammatory hip disease who were under the age of 35 at the index operation and on which 57 primary total hip arthroplasties were performed between 1989 and 2001. Polished straight tapered cemented stems were used in all 57 hips. There were 10 cemented and 47 uncemented cups. The average follow-up was 12.2 years (range 7-19). Forty-seven hips had more than 10 years follow-up. There were 3 revisions of cemented metal-backed cups for aseptic loosening at 11, 13 and 16 years post-operatively. No uncemented cups and no stems needed revision. Heterotopic ossifications occured in 3 hips with Brooker type-I ossification in 1 hip and Brooker type-II in 2 hips. Cemented polished tapered straight stems demonstrate excellent survival in young patients suffering from inflammatory arthritis.