357 hips were randomized to compare the clinical outcome and wear rate of two different bearing surfaces for total hip arthroplasty (THA). Patients received either ceramic-ceramic or ceramic-polyethylene bearings and were assessed at 60 months. Results revealed that there were no significant differences in clinical outcome between the two bearings at any time point. However, the mean linear wear rate was significantly lower in the ceramic-ceramic group when compared to the ceramic-polyethylene group. Further long-term assessments are required to assess potential differences in revision rates and complications.