In total hip replacement (THA) surgery, both sides of the ball-and-socket joint of the painful arthritic hip are surgically removed and replaced with artificial joint surfaces made of special materials. The materials, usually metal and plastic, have been designed to provide long-lasting pain relief and excellent function. This very common procedure has traditionally been associated with excellent results in most patients but also with significant pain after surgery and frequently a prolonged recovery. Recent advances in surgical technique, including minimally invasive surgical approaches where soft tissue dissection, especially muscle, is minimized and a small (3 to 6 inch) incision is used, have lessened the pain in most patients and hastened recovery, shortening the hospital stay from 3 or more days to 2 or even 1 day for most patients. Additionally, upgrades in pain management, including ‘pre-emptive analgesia’ (giving pain medicine proactively before the surgery), ‘mutimodal analgesia’ (using pain medicines from different classes of medicines), and using regional anesthetic techniques such as spinal anesthetic and/or nerve blocks, have improved the experience for our patients. The surgeons at Maineortho use mini-posterior, anterolateral, direct anterior, and modified Hardinge approaches, depending on patient factors such as size and age and surgeon preference. All of these surgical approaches allow us to position and secure the implant in the correct position, which is the key to long-term success in hip replacement surgery.