80 patients (91 hips) were randomized to evaluate the clinical and radiographic outcomes associated with conventional (UHMWPE) or crosslinked (HXLPE) polyethylene liners, paired with either oxidized zirconiu (oxinium; Ox) or cobalt-chromium (Co-Cr) femoral heads. Patients received either CoCr/HXLPE; Ox/HXLPE; CoCr/UHMWPE; or Ox/UHMWPE. Patients are currently being monitored up to 10 years postoperatively, with 2- and 5-year clinical and radiographic results presented here. Analysis of linear wear rate at a mean follow-up of 6.8 years demonstrated significantly lower wear with HXLPE liners, irrespective of the type for femoral head used. Linear wear rate was approximately 3x lower with the HXLPE liner compared to the UHMWPE liner. No significant difference between Ox and CoCr femoral heads was noted for either liner type.