There is good justification for acclaiming total hip replacement as the most significant clinical advance in orthopedics in the past decade. To Mr. John Charnley, and his staff, goes the well deserved credit for this contribution which has returned thousands of people, disabled by hip disease, to an active, painfree status. In 1969, a series of total hip replacements, adhering generally to the techniques established at the Wrightington Hip Center, was begun. Between March of 1969, and February of 1972, 34 cases were done. The cases were reviewed and the results analyzed. Because of a complication rate which was judged to be high, the technique was revised radically. The complications which were most frequent and most disturbing, were those relating to the trochanteric removal and replacement. The posterior approach to the hip was selected as an alternative because the normal bed-lying position of external hip rotation is the position of stability, and because the trochanter need not be removed. The necessity of adjusting for leg length and soft tissue tension required the use of a variable neck length implant (Charnley-Muller, Aufranc-Turner, or Harris). Between February of 1972, and March of 1973, the author did 26 replacements using the revised technique. This paper sets out to compare these techniques, in the hands of one surgeon, as regards complications and relative success.