Total hip arthroplasty (THA) in patients with sequelae of the hip joint infection is a technically challenging procedure. In addition, the majority of such patients are less than fifty years old, so it has been reported that they have higher prevalence of complication and failure of component fixation. Alumina-on-alumina couplings are an attractive alternative and may offer a promising option for such young active patients. We analyzed 33 primary cementless alumina-onalumina THAs (PLASMACUP®SC-BiCONTACT® system incorporating BIOLOX® forte) that had been performed in patients who had sequelae of the hip joint infection. The average age of the patients was 37.8 years (range, 19-68 years) and 26 patients were younger than 50 years old. They were followed-up for more than 5 years (average, 74 months; range, 60-93 months). All hips had no recurrence of hip joint infection. The mean Harris hip score improved from 59.8 points to 93.5 points. All of the implants had radiographic evidence of a bone ingrowth and no radiological loosening was found. During the follow-up period, no cup or stem was revised and no periprosthetic osteolysis was observed. Nonunion of the osteotomized greater trochanter occurred in one hip, but no postoperative infection or ceramic failure was observed. The 5-year minimum follow-up clinical results of modern alumina-on-alumina THAs performed in patients with sequelae of the hip joint infection were encouraging with regard to osteolysis and implant stability. Our findings show that this alternative articulation offers a reliable solution for these young patients with long-standing anatomic abnormalities of the bone and soft tissues.