72 patients undergoing primary total hip arthroplasty were included in this randomized controlled trial to compare mid-term outcomes of two different surgical approaches. Patients were randomized to either a mini-incision posterior approach or a two-incision approach. At a mean follow-up of 8 years, a total of three revisions in the mini-incision group and two revision in the two-incision group had been required. There were no significant differences in Harris Hip Score, SF-12 physical & mental components, or patients perception of the operated hip as percentage of normal.