287 patients undergoing total hip replacement (THR) surgery were randomized to receive either a cementless porous-coated cobalt-chromium acetabular component with polyethylene liner (PFC) or a cemented all-polyethylene acetabular component (Ultima) to compare long-term clinical and radiological outcomes. Harris hip score (HHS) was recorded over a 10 year period, and replacements were monitored for radiolucencies (device loosening). Results indicated that there was no difference between the two groups based on mean HHS change from pre-operative values at any time during the follow-up period, but the Ultima devices had statistically higher incidences of radiolucencies.