320 patients with primary hip osteoarthritis undergoing total hip arthroplasty were randomized to receive either oral tramadol/dexketoprofen (Group A, n=188) or intravenous paracetamol plus tramadol (Group B, n=135). The primary outcome of interest was the reduction in pain intensity measured by the visual analogue scale (VAS) over 48 hours postoperatively. Secondary outcomes included the need for rescue medication, safety profiles, and the percentage of responders (patients achieving at least 30% pain reduction). Outcomes were assessed at 2, 8, 24, 48 hours, and at 2 weeks postoperatively. Overall, the study revealed that patients receiving tramadol/dexketoprofen had a significantly faster and greater reduction in pain, with less need for rescue medication (p < 0.001). This suggests that oral tramadol/dexketoprofen provides more effective pain control in the immediate postoperative period after THA.