The principles of the hip arthroplasty, as we know them today, were established about 60 years ago by Sir John Charnley. Replacement of the hip joint became one of the most successful and safest therapeutic procedures. Hip arthroplasty has been shown to yield good long-term results without complications. Over the last 20 years, the development and establishment of minimally invasive operation techniques has contributed to rapid changes. Additionally, perioperative patient management was optimized. Improvements in the material and tribology of the implants led to promising developments. Nonetheless, analysis of possible complications, shows potential for further developments, for example in cup geometry. Enhanced training concepts for surgeons, operation simulators, simple navigation aids for component positioning can surely achieve improvements in surgical safety.