80 patients (91 hips) who were scheduled to receive total hip arthroplasty were randomly assigned into 1 of 4 groups to compare the clinical and radiological outcomes of four bearing surface combinations. The four combinations were: cobalt-chrome (CoCr) on standard, ultra-high-molecular-weight polyethylene (UHMWPE), CoCr on cross-linked polyethylene (XLPE), Oxinium (Ox) on UHMWPE, and Oxinium on XLPE. At an average of 6.8 years follow-up, XLPE liners demonstrated reduced linear wear rate when compared to UHMWPE liners, irrespective of the femoral head that was used (either oxinium or cobalt-chrome).