100 patients scheduled for total hip arthroplasty were randomized to undergo the procedure with a solid-backed or cluster-hole acetabular component (fixed without screws). The purpose of this study was to compare the incidence rate of osteolysis, volume of osteolytic lesion, and functional outcomes scores between acetabular components over a 5-year follow-up period. Results demonstrated that solid-backed and cluster-hole components were comparable for all outcomes. The hypothesized risks/complications of cluster-hole acetabular components were not observed, indicating that there may no longer be a significant drawback to the use of cluster-hole components (with optional screw fixation).