70 adult patients undergoing primary total hip arthroplasty were randomized to receive negative-pressure wound therapy (NPWT) or standard wound dressings after surgery in this pilot RCT. The purpose of this pilot was two-fold: to perform a preliminary analysis on the effects of NPWT in terms of surgical site infection risk compared to standard care, and to determine the feasibility of a definitive RCT on this topic. Results showed no significant differences in terms of surgical site infection risk between groups, but NPWT was found to significantly increase the risk of bleeding and overall risk of wound complication compared to standard dressing. Additionally, NPWT was associated with significantly greater costs compared to standard care. Future studies on NPWT efficacy were deemed necessary and would require approximately 900 patients per group based on the results of this study.