We reviewed the clinical results of the Indiana conservative hip arthroplasty in 116 hips with a two to seven-year follow-up. There were seventeen failures (14.6 per cent). The rate of non-traumatic loosening was 10 per cent and the failure rate for patients with inflammatory arthritis was 33 per cent. No infections, dislocations, subluxations, pulmonary emboli, or deaths were associated with the procedure. For forty-two hips with a successful result and a minimum follow-up of three years, the radiographs were analyzed. Factors that were found to have a high correlation with success of the arthroplasty were preservation of the acetabular subchondral bone, complete coverage of the acetabular component, and selection of the appropriate sizes of femoral and acetabular components. Radiolucency was not found to be a reliable diagnostic sign of, or prelude to, symptomatic loosening of the prosthetic implant.