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 .
Cemented versus cementless stems: a verdict is in.
The purpose of this r and omized clinical trial was to compare the > 20-year outcomes of cemented ( n=124 ) versus cementless ( n=126 )  total hip replacements ( THRs ) in patients with end-stage , unilateral hip osteoarthritis . At 20 years , 168 patients ( 67 % ) were available for follow-up , 78 ( 31 % ) had died , and 4 ( 2 % ) were lost . A power analysis was performed to determine the number of patients needed in each study cohort . Patients were assessed pre- and postoperatively by vali date d disease-specific Western Ontario McMaster Osteoarthritis Score , patient-specific McMaster Arthritis Score , global health ( sickness impact profile ) , functional capacity ( 6-minute walk ) , and cost utility ( cost-to- quality adjusted life years ) . Patients were followed every 2 years clinical ly and radiographically . The cementless THR outperformed its cemented counterpart in terms of overall ( P=.01 ) , socket ( P=.009 ) , and stem ( P<.0001 ) Kaplan-Meier survivorships . Patients younger than 65 years had significantly poorer cemented and cementless socket survivorships , and male sex adversely affected cementless socket survivorship . The cementless tapered stem had 100 % survivorship with aseptic loosening as the endpoint at 20 years . Although this study has demonstrated the superiority of the cementless THR over its cemented counterpart , care must be taken in generalizing these results to other cemented and cementless THRs
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 .