Since the first successful total hip arthroplasty (THA) 28 years ago, this procedure has enabled millions of people to walk without pain. The overall incidence of THA has more than tripled in the last five years, now exceeding 196,000 cases annually. The direct and indirect costs of THA exceed $4.9 billion annually. Though the economic benefits of THA offset this figure by $1.85 billion, the costs nevertheless have a significant impact on the health care system. Although THA is expensive, the excellent long-term results make it well worth the expense.