A total of 223 total hip arthroplasties(THAs) in 215 consecutive patients were operated using the Anatomic Medullary Locking hip system. In this study, we compared the incidences of reoperation, clinical results, and radiographic findings between young(<60 years old: 1 1 1 hips in 105 patients) and elderly patients((>-60 years old; 88 hips in 86 patients) at a minimum of five year follow-up. Twelve patients(1 young and 11 elderly) died before five year follow-up and twelve patients(8 hips in 7 young patients and 4 hips in 4 elderly patients) were lost to follow-up. The incidence of reoperation of the young group(15.3%) was significantly higher than that of the elderly group(3.4%). Excellent clinical results were obtained in both groups with 96% of the young group and 93% of the elderly group reporting they were satisfied with their hip arthroplasty. In radiological analysis, the incidences of osteolysis(acetabular and femoral) and acetabular mechanical failure in the young group(15.3%) were significantly higher than those in the elderly group(5.7%). These results suggest that porous-coated total hip arthroplasty is an effective treatment option for painful arthritic hips in elderly patients.