80 patients scheduled for a total hip arthroplasty were randomized to receive femoral implantation using CT-based, 3D-printed patient-specific guides (n=40) or conventional pre-operative planning (n=40). The primary outcomes of interest included radiographic alignment measures including leg length discrepancy, femoral offset, and stem placement. Secondary outcomes of interest included peri-operative outcomes, pain on a Visual Analog Scale (VAS) and Harris Hip Scores (HHS). Outcomes were assessed up to 12 months post-operation. Results revealed all radiographic alignment outcomes to be significantly in favour of the patient-specific guide group. No differences in operative time, blood loss, or VAS pain scores were observed, however, HHS scores up to 3 months post-operation were significantly in favour of the patient-specific guide group.