Patients experienced significant post-THR improvements in Harris Hip scores , but this did not differ between impact types .
Recipients of cross-linked vs. conventional polyethylene cup liners experienced reduced femoral head penetration and revision .
There was no impact of femoral stem fixation and cup shell design on implant survival rates .
Evidence on mortality and complications ( aseptic loosening , femoral fracture ) was inconclusive .
BACKGROUND Evolvements in the design , fixation methods , size , and bearing surface of implants for  total hip replacement ( THR ) have led to a variety of options for healthcare professionals to consider .
The need to determine the most optimal combinations of THR implant is warranted .
This systematic review evaluated the clinical effectiveness of different types of THR used for the treatment of end stage arthritis of the hip .
Alumina Ceramic Bearings for Total Hip Arthroplasty: Five-year Results of a Prospective Randomized Study
Three hundred twenty-eight ceramic bearings were implanted by six surgeons in 316 patients as a part of a prospect i ve r and omized US Investigational Device Exemption study comparing alumina ceramic bearings with cobalt chrome-on-polyethylene bearings . There was no difference between the control metal-on-polyethylene and the alumina bearing couple patient cohorts regarding demographics or clinical scores through 7 years . Revision for any reason occurred in 2.7 % of the patients with alumina bearings and 7.5 % of the control patients with polyethylene bearings .  Osteolysis was found in 1.4 % of the patients with alumina bearings and in 14.0 % of the control patients . At an average followup of 5.0 years ( range , 1 - 86 months ) no ceramic fractures or ceramic bearing failures have occurred . Results of this study suggest that alumina ceramics  perform as well as the metal-on-polyethylene in clinical scores , but the patients with ceramic bearings had fewer revisions and less osteolysis . These results lead us to think that this new alumina ceramic bearing provides a safe option for younger and more active patients . Level of Evidence : Therapeutic study , Level I-1b ( r and omized controlled trial , no significant difference , but narrow confidence intervals ) . See the Guidelines for Authors for a complete description of levels of evidence
Patients experienced significant post-THR improvements in Harris Hip scores , but this did not differ between impact types .
Recipients of cross-linked vs. conventional polyethylene cup liners experienced reduced femoral head penetration and revision .
There was no impact of femoral stem fixation and cup shell design on implant survival rates .
Evidence on mortality and complications ( aseptic loosening , femoral fracture ) was inconclusive .
BACKGROUND Evolvements in the design , fixation methods , size , and bearing surface of implants for  total hip replacement ( THR ) have led to a variety of options for healthcare professionals to consider .
The need to determine the most optimal combinations of THR implant is warranted .
This systematic review evaluated the clinical effectiveness of different types of THR used for the treatment of end stage arthritis of the hip .