Fifty-eight patients undergoing direct anterior approach THA were randomized to receive Pericapsular Nerve Group (PENG) with lateral femoral cutaneous (PENG+LFCN)(n=29) or the Fascia Iliaca Compartment Block (FICB), (n=29) under a standardized spinal and multimodal analgesic regimen. The primary outcome was quadriceps strength (MRC) at 6 h. Secondary outcomes included active hip flexion, static/dynamic pain (NRS) at 6/24/48 h, opioid consumption (MME), time to ambulation, and adverse events. Outcomes were assessed up to 48 h. Overall, the results showed higher MRC scores at 6 h with PENG+LFCN, alongside greater hip flexion at all time points, lower pain scores, and markedly reduced opioid use. These findings suggest PENG+LFCN offers superior motor-sparing analgesia and early functional advantages over FICB after THA.