100 patients undergoing total hip arthroplasty were included in this randomized controlled trial to determine the effect of surgical approach on the speed of functional recovery. Patients were randomized to total hip arthroplasty using either a direct anterior approach (DAA) or a mini-posterior approach (MPA). The outcomes measures included the time to achieve functional milestones, advanced activity assessed with activity trackers, postoperative pain, opioid consumption, and complications. The results of this trial indicated that patients in the DAA group attained functional milestones significantly earlier (discontinue walker use, discontinue gait aid use, ascend stair with a gait aid, and walk 6 blocks) and performed significantly greater amounts of functional activity for the first 2 postoperative weeks. There were no significant differences observed between groups at 2 months or 1 year. Opioid consumption and pain scores during hospital stay did not significantly differ between the two groups.