Osteochondral defects of the femoral head represent a major challenge and various modern treatment options exist. We report a 16-year-old male with a large (3 x 3 cm) osteochondral defect of the femoral head that was treated with a partial resurfacing prosthesis combined with a high varus osteotomy, performed by surgical dislocation of the hip. Two years after surgery the patient was progressing well without complications.