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 .
Comparison of Total Hip Arthroplasty Performed with and without Cement: A Randomized Trial
Background : This study was design ed to compare the fixation of a Mallory-Head total hip prosthesis with and without cement . Methods : Two hundred and fifty patients with osteoarthritis of the hip were r and omized to receive a Mallory-Head total hip prosthesis design ed for insertion with cement or the same prosthesis design ed for insertion without cement . Neither the patient nor the outcomes assessor was aware of the type of prosthesis . Outcomes were assessed with respect to mortality , revision arthroplasty , health-related quality of life ( evaluated with the Harris hip score , Merle d'Aubigné and Postel hip score , McMaster-Toronto Arthritis Patient Preference Disability Question naire ( MACTAR ) , Western Ontario and McMaster University Osteoarthritis Index ( WOMAC ) , and the time trade-off technique ) , and the six-minute-walk test . Patients were seen at three , six , and twelve months and yearly thereafter . Results : The prosthesis was inserted with cement in 124 patients and without cement in 126 patients . The mean age of the patients was sixty-four years , 48 % were female , and the mean duration of follow-up was 6.3 years . There were thirteen revisions in the group that had fixation with cement and six in the group that had fixation without cement ( p = 0.11 ) , and more femoral components were revised in the group that had fixation with cement ( twelve versus one ; p = 0.002 ) . All health-related quality -of-life measures improved postoperatively in both groups . Conclusions : In this r and omized trial , the group that had the cemented Mallory-Head hip prostheses required more revisions of the femoral component than did the group with the cementless Mallory-Head prostheses , which was perhaps related to the titanium-alloy femoral stem . Our findings are specific to the implants evaluated in this study
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 .