One hundred and ninety osteoarthritis patients (n=219) scheduled for a total hip arthroplasty procedure performed via direct anterior approach were randomized to receive anterior capsule sparing (n=104 hips) or anterior capsule resection (n=115 hips). The outcomes of interest included function measured by the Harris Hip Score (HHS), the Hip Disability and Osteoarthritis Score (HOOS) and associated sub-scores (i.e., activities of daily living; pain; quality of life; sport; symptoms), the Short-Form 36 (SF-36) quality of life survey, socket inclination and anteversion, femoral component coronal alignment, the incidence of radiolucent lines, response rate, and the incidence of adverse events (i.e., myalgia; lumbalgia; meralgia; intraoperative events; wound problems; psoas irritation; groin pain with psoas tendinitis). Outcomes were assessed 1 year post-operation. Results revealed no statistical significant differences between the two groups in all outcomes (p>0.05 for all).