Anterior approach total hip replacement has generated quite a bit of interest in the lay press and as well as on the Internet. There have been numerous success stories, but also recent reports of a more complicated operation with longer operative time and increased blood loss. We recently received clearance from the Western Institution Review Board for a study comparing anterior approach total hip replacement to posterior approach total hip replacement. We will be using the same implant, same techniques, and same postoperative protocols. We plan on comparing the amount of postoperative pain, return to activity and function, and results and complications to compare the two techniques. We are currently enrolling patients for this ongoing prospective randomized study and are excited about reviewing some of the claims about anterior hip replacement in a scientific way.