51 patients with primary osteroarthritis undergoing total hip arthroplasty (THA) were randomly assigned to receive either conventional highly cross-linked polyethylene (HXLPE) liners or vitamin E (α-tocopherol) treated HXLPE liners. The purpose of this study was to investigate whether vitamin E treated HXLPE liners resulted in lower polyethylene wear compared to the conventional HXLPE liners up to 2 years after surgery. The primary outcome measure was prosthetic head penetration into the polyethylene liner, and secondary outcomes included hip function and health-related quality of life. The results demonstrated no significant difference at 2 years after surgery in terms of total head penetration between the two groups, though significant differences at 12 months after surgery were noted favoring the vitamin E treated liners. Both treatments significantly improved hip function and patient quality of life, with no significant difference between them.