One hundred and ninety-nine patients scheduled for a primary total hip arthroplasty were randomized to receive a Vitamin E infused highly cross-linked polyethylene (HXLPE) acetabular cup or an ultra-high molecular weight polyethylene (UHMWPE) acetabular cup. The primary outcome of interest was wear rate measured by femoral head penetration rate. Secondary outcomes of interest included pain at rest and during load, patient satisfaction, and Harris Hip scores. Outcomes were assessed up to 2 years post-operation. Results revealed no significant differences in femoral head penetration rate between the two groups. Patient satisfaction and Harris Hip Scores at 2 years were significantly in favour of the Vitamin E infused group. No significant differences in pain scores at rest or during load were observed between the two groups.