148 patients scheduled for total hip arthroplasty were randomized to either a direct anterior or transgluteal lateral approach. The primary outcome was the number of steps taken per day in the period leading up to 3- and 12-month follow-up. The highlighted secondary outcome measure was the Harris Hip Score, while other secondary outcome measures included the Short Musculoskeletal Functional Assessment (SMFA) function and bother scales, patient-reported activity level on a visual analog scale, and Timed 25-meter walk test. Results demonstrated a significantly greater number of daily steps taken at 3- and 12-month follow-up in the direct anterior approach group compared to the transgluteal approach group, while no significant difference in Harris Hip Scores was observed between groups.