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 .
Wear rate of highly cross-linked polyethylene in total hip arthroplasty. A randomized controlled trial.
BACKGROUND Highly cross-linked polyethylene was introduced for clinical use in total hip arthroplasty with the expectation that it would exhibit less wear when compared with conventional polyethylene . The purpose of this study was to report the clinical and radiographic results , after a minimum of five years of follow-up , of a r and omized , blinded , controlled trial comparing a conventional polyethylene with a first-generation highly cross-linked polyethylene . METHODS One hundred patients were enrolled in a prospect i ve , r and omized controlled study comparing highly cross-linked and conventional polyethylene acetabular liners in total hip arthroplasty . Fifty patients were in each group . At the time of follow-up , clinical outcomes were assessed and steady-state femoral head penetration rates ( after bedding-in ) for each patient were calculated with use of a vali date d radiographic technique . In addition , a statistical comparison of polyethylene wear between groups was performed with use of generalized estimating equations . RESULTS At a mean of 6.8 years postoperatively , there were no differences between the two polyethylene groups with regard to the Harris hip score , Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) , or Short Form-12 ( SF-12 ) score . The mean femoral head penetration rate in the first through fifth years was found to be significantly lower in the group treated with the highly cross-linked polyethylene ( 0.003 mm/yr [ 95 % confidence interval , + /-0.027 ] ) than it was in the group treated with conventional polyethylene ( 0.051 mm/yr [ 95 % confidence interval , + /-0.022 ] ) ( p=0.006 ) . Men treated with a conventional polyethylene liner had a significantly higher ( p < or=0.012 ) femoral head penetration rate ( 0.081 mm/yr [ 95 % confidence interval , + /-0.065 ] ) than both men and women with a highly cross-linked liner ( -0.013 mm/yr [ 95 % confidence interval , + /-0.074 ] and 0.009 mm/yr [ 95 % confidence interval , + /-0.028 ] , respectively ) . The general estimating equations demonstrated that the group with a highly cross-linked polyethylene liner had a significantly lower femoral head penetration rate than the group with a conventional polyethylene liner ( p=0.025 ) , and a significantly higher femoral head penetration rate was demonstrated in men with a conventional polyethylene  liner when compared with both men and women with a highly cross-linked liner ( p=0.003 ) . CONCLUSIONS At a minimum of five years postoperatively , the steady-state femoral head penetration rate associated with this first-generation highly cross-linked polyethylene liner was significantly lower than that associated with a conventional polyethylene liner . Long-term follow-up is required to demonstrate the clinical benefit of this new material
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 .