50 patients (55 hips) scheduled for primary total hip arthroplasty were randomized to receive implants with hydroxyapatite applied either via electrochemical deposition or plasma-spray. The purpose of this study was to determine whether differences exists between methods with respect to bone density loss, aseptic loosening, periprosthetic migration and functional scores when evaluated up to 5 years post-surgery. Results demonstrated that although patients in the plasma-spray group demonstrated significantly less loss in bone mineral density and decreased retroversion rates at certain time-points, the two methods of hydroxyapatite application were deemed to be clinically comparable.