Fifty patients with femoral neck fractures were randomized to receive total hip arthroplasty via the Direct Anterior Approach (n=25) or the Direct Lateral Approach (n=25). The primary outcome of interest was the Harris Hip Score (HHS) for functional recovery. Secondary outcomes included incision length, intraoperative blood loss, postoperative pain, operative times, and complications such as cup positioning and neuropraxia. Outcomes were assessed at 48 hours, 3 months, 6 months, 1 year, and 2 years postoperatively. Overall, the results showed that the Direct Anterior Approach resulted in a shorter incision, less blood loss, and faster functional recovery at 3 months, but no differences were observed at 6 months or beyond. The findings suggest early functional advantages with the Direct Anterior Approach, but similar long-term outcomes compared to the Direct Lateral Approach.