46 patients scheduled for a total hip arthroplasty were randomized to receive an existing cementless hydroxyapatite coated stem or a novel cementless hydroxyapatite coated stem with increased coating and a blended compaction extraction femoral broach. The primary outcome of interest was stem migration, as measured by radiostereometric analysis imaging for subsidence, tilt, anteversion-retroversion, and maximum total point motion. Patient-reported outcome measures for function, quality of life, and pain were also measured, as well as duration of walking aid use. Outcomes were assessed up to 24 months post-operation. Whilst both groups demonstrated improvement from pre-surgery levels, no differences in all outcomes were observed between the two groups suggesting that existing hydroxyapatite-coated stems provide comparable clinical outcomes to the novel stem with additional coating.