One hundred thirty-four consecutive primary total hip arthroplasties, with 100 uncemented and 34 hybrid cemented femoral components, were performed in 119 patients in a community hospital setting, and the patients were followed for between 2 and 4 years. Two-year followup mean Harris hip ratings were 88 for the hybrid group and 90 for the porous coated group. The pain score was 43 for both groups. The incidence of thigh pain was 9% at 1 year, 6% at 2 years, and 5% at 3 years in the porous coated group; none of the pain was disabling. A persistent limp was noted in 19% of patients: 18% of the porous coated group and 22% of the hybrid group. Limp was believed to be related to the number of prior hip surgeries, preoperative leg length discrepancy greater than 2.7 cm, and comorbid musculoskeletal diseases, and not to utilization of the modified direct lateral approach. Radiographic zonal analysis revealed that 99 of the porous coated femoral components had a stable implant fixation with bone ingrowth; one component was stabilized by fibrous ingrowth. The average femoral size used was two sizes larger than those used elsewhere, when the same prosthesis was used during the same time interval. These results obtained in a community hospital setting using either modern cemented or porous-coated insertion techniques are similar to those achieved in major medical centers.