Total hip arthroplasty (THA) is a highly effective intervention for degenerative hip disease, being among the most performed surgeries in the United States. Despite advancements, the need for revision THA is expected to increase significantly within the next decade. Often, the goals of revision surgery include addressing bone deficiencies in the femur and/or acetabulum. Calcar replacing stems, dating back to the 1970s, are a useful tool for proximal femoral bone reconstruction. They can be useful in cases of bone deficiency or hip fractures. Calcar replacing stems offer stability and function, with options for cemented or cementless fixation. Literature reviewing long-term follow-up after use of a calcar replacing stem along with author preferences for revision hip surgery is discussed within the chapter.