57 young patients (18-60 years of age) scheduled for elective, primary total hip arthroplasty were included in this study to compare long-term wear, revision, and functional outcomes between ceramic-on-ceramic and ceramic-on-conventional polyethylene bearing surfaces. This study presented the result at a minimum 15-year follow-up. Total wear, linear wear rate, and the incidence of femoral osteolysis were greater among patients who were given a ceramic-on-conventional polyethylene implant compared to patient given a ceramic-on-ceramic implant. Nonetheless, no significant difference was observed between groups in revision rate or functional outcome measures.