A cutting guide for removing a lesion from a neck area of a femur has a body having first and second side rails. The first and second side rails are spaced in a direction perpendicular to the head neck axis of the femur when mounted adjacent a neck of the femur. A third rail has ends slidably mounted on the first and second side rails. The third rail can be resiliently deformable toward a surface of the neck of the femur. A carrier element slidably mounted on the third rail for movement therealong between the first rail and the second rail. A bone cutting tool such as a burr is mountable in the carrier element. The first and second rails are connected by a proximal rigid cross-member at first ends thereof adjacent a femoral head. The cross-member is shaped to conform to an outer surface of the femoral neck adjacent the femoral head. The second ends of the first and second rails are connected by a member having a mounting element thereon adjacent a trochanter area of the femur. The mounting element may be a bore for receiving a bone screw or bone pin.