A comparative study of the Wagner resurfacing arthroplasty and Total Articular Replacement Arthroplasty (T.A.R.A.) has been reviewed in 98 patients. The Wagner procedure failed at a significantly greater rate than the T.A.R.A. procedure (24% to 0, respectively). Failure in the Wagner series centered around acetabular and femoral component loosening, as well as cervical neck fracture. The stemmed T.A.R.A. femoral component appears to offer significant fixation by design and application. However, disturbing in both groups was the high incidence of radiolucency about the thin-walled acetabular components (31%, Wagner series; 49%, T.A.R.A. series). The merits of conservative total hip replacement in terms of preservation of bone stock, with the consequently greater salvage alternatives, appear attractive; however, the durability of these procedures remain in question, especially in view of the short-term followup in this review. Caution and further observation are in order before definite conclusions can be reached about the therapeutic contribution of conservative total hip replacement.