Implementation of total hip arthroplasty is a successful and reliable treatment for end-stage osteoarthritis. The biomechanics and components as well as the fixation were selected with the aid of templating. Based on a cohort of 114 patients the quality of digital X-rays and the operative results were determined. There was a slight leg lengthening and a good offset reconstruction in these patients. For the patients with replacement of the second hip the leg lengthening was smaller. The cup inclination was at 43° and 44° within the desired range. The prediction of the exact component size used was 40% for the cup and 29% for the stem.Through variation in scaling of the digital X-ray a diminishing prediction accuracy was found in our study. The correction of biomechanics and position of components showed good quality in patient care. Templating and assessment of the postoperative result in total hip arthroplasty is a model for continuous quality management and can be recommended for safe patient care.