AIM: The aim of this prospective randomized study is to evaluate the early functional advantages in gait rehabilitation after minimally invasive total hip replacement (THR). METHOD: Twenty one patients underwent a THR using a modified minimally invasive anterolateral Watson Jones approach and twenty patients got a hip replacement using the transgluteal Bauer approach. The effects in gait rehabilitation were measured by gait analysis and compared to healthy subjects preoperatively as well as 6, 13, 27 and 47 weeks postoperatively. The comparison of the walking speed is achieved by given step frequencies using a metronome. RESULTS: The advantages of the minimally invasive technique in the re-establishment of the symmetry in single limb stance time and in mechanical load are more constant than expected. However the deficits still exist one year postoperatively. The differences between MIS and standard approach, at week 6 and 13 postoperatively, decrease one year after surgery. As opposed to the MIS group the comparison of week 47 in relation to the results prior to the surgery shows only slight improvements. CONCLUSION: The results of this study should be verified by the investigation of the pathological gait pattern and with a larger population. For longitudinal analyses a standardized methodical investigation with comparable walking speed is essential.