Abstract
BACKGROUND: Total hip arthroplasty (THA) has changed significantly since its inception, with various bearing surfaces affecting clinical outcomes. This systematic review aimed to assess the functional results of various bearing surfaces in total hip arthroplasty using validated scoring systems. METHODS: This systematic review was carried out in accordance with PRISMA guidelines, and the protocol was registered in PROSPERO under CRD42025634591. Studies were included based on predefined criteria for population, intervention type, and reported clinical outcomes. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Harris Hip Score (HHS), and SF-12 were analyzed closely. RESULTS: 18 clinical trials with a mean follow-up of 100.69 months were included. MoM implants showed superior HHS, WOMAC, and SF-12 scores compared to CoC, CoP, and MoP (P<0.001), suggesting better quality of life and improved functional outcomes. CoM showed slightly better WOMAC scores over MoM, but the difference was not statistically significant. The most common reason for revision was dislocation (36 cases), while osteolysis was the most common complication (43 cases). CONCLUSION: MoM implants demonstrated better quality of life and functional outcomes, but their use has declined due to safety concerns. Other implants may reduce complications related to metal ion release. These findings help surgeons choose THA implants by weighing benefits against long-term risks. Further research is necessary to refine implant selection criteria and long-term performance.