A joint replacement prosthesis and procedure reduce the number of steps to complete a joint replacement. The joint replacement prosthesis comprises a ball and socket unit that fixes the ball in the socket prior to surgery. The unit is coupled to a bone structure in the patient and is coupled with a prosthesis that is fixed to another bone of the patient, such as a femoral implant fixed in a femur and providing a coupling at the end of a neck portion that is easily fit into a femoral head and acetabulum unit. A tether may be used to retain the ball in the socket and/or the ball may be retained by extension in the socket that do not restrict patient motion.