A miniature horse presented to the Orthopedic Surgery Service at the Cornell University Equine and Farm Animal Hospital with a chief complaint of an acute, non-weight bearing lameness of the left hind limb. Approximately 24 hours earlier, the owner had found the horse standing in his stall with the limb held in an abnormal position. The rDVM presumptively diagnosed a coxofemoral luxation, and referred the horse into Cornell for further evaluation and treatment. Physical exam and radiography confirmed a craniodorsal coxofemoral luxation of the left hip joint. The horse had a previous history of upward patellar fixation, and the left stifle was locked but could be manually reduced with substantial effort. He was placed under general anesthesia, a closed reduction of the luxation was successfully performed. He was placed in a Modified Ehmer sling and hand recovered. Within 48 hours, the sling had failed and re-luxation had occurred. The following day, Mel was brought to surgery for an open reduction of the luxation, and a prosthetic capsulorraphy was performed to prevent subsequent luxation. He was discharged one week later, but within 24 hours of leaving the hospital, re-luxated subsequent to a long trailer ride. He returned to Cornell where a second surgery was performed, revealing the prosthesis to have pulled through the used in the second prosthetic capsulorraphy, and the horse was successfully discharged to his owners.