Ninety hips in 82 patients using Omnifit hydroxyapatite (HA)-coated prosthesis were followed for at least 7 years. All stems were stable at the final follow-up. However, aseptic loosening was found in 8 cups and 6 of them were revised. Two polyethylene wear were treated with inserts exchanged. The mechanical failure rate was 11.4% and the combined failure rate was 14.3% for HA-coated cup. Four other cups with wear and osteolysis without loosening or pain and 2 cups with polyethylene wear without osteolysis were still under observation. Our findings suggest that hip arthroplasties with HA coating on the smooth surface of a titanium cup is not reliable. The mid-term result of HA-coated stem is as good as that of porous-coated stem.