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 .
A prospective, randomized study of cross-linked and non-cross-linked polyethylene for total hip arthroplasty at 10-year follow-up.
In 1999 , our institution initiated a prospect i ve study to compare the outcome of total hip arthroplasty patients r and omized to either non-cross-linked liners or polyethylene liners that were cross-linked with 5.0 Mrad of gamma-irradiation and heat treated to eliminate free radicals . Among 230 r and omized THAs , 13 have had reoperations , and 31 patients with 32 THAs died with less than 9-year follow-up . Follow-up for the remaining 185 THAs averaged 10.0 ± 1.8 years . There have been 9 wear-related liner exchanges among the non-cross-linked group and none among the cross-linked group . Using revision for wear-related complications as an endpoint , survivorship at 10-years was 94.7 ± 4.6 % for non-cross-linked and 100 % for cross-linked ( P = .003 ) . Among unrevised hips , the mean linear wear rate was 0.22 mm/yr for non-cross-linked and 0.04 mm/yr for cross-linked ( P < .001 ) . The incidence of clinical ly important osteolysis with an area of at least 1.5 square centimeters among unrevised hips was 22 % for non-cross-linked and 0 % for cross-linked ( P < .001 )
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 .