en Orthopedic Surgery Orthopedic Surgery Review Article Review Article <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><b><span style="font-size:9.0pt"><span style="font-style:normal">Background: </span></span></b><span style="font-size:9.0pt"><span style="font-style:normal">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.</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; <b>Methods:</b> 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. </span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><b><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp;&nbsp; Results:</span></span></b><span style="font-size:9.0pt"><span style="font-style:normal"> 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 (</span></span><span style="font-size:9.0pt">P</span><span style="font-size:9.0pt"><span style="font-style:normal"><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).</span></span></span></span></span></span></span></span><br> <span style="font-size:13pt"><span style="text-justify:kashida"><span style="text-kashida:0%"><span style="text-autospace:none"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-style:italic"><span style="font-size:9.0pt"><span style="font-style:normal">&nbsp; <b>Conclusion:</b> 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.</span></span></span></span></span></span></span></span><br> &nbsp; Hip Prosthesis, Arthroplasty, Bearing Surface, Implant, metal-on-metal, ceramic-on-polyethylene, Treatment Outcomes 997 1009 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-7348-6&slc_lang=en&sid=1 Amirhosein Sabaghian amir.hs200281@gmail.com 200319475328460093427 200319475328460093427 No School of Medicine, Iran University of Medical Sciences, Tehran, Iran Amirhosein Shahbazi amirhossein.shahbazi23@gmail.com 200319475328460093428 0009-0007-1456-018X No School of Medicine, Ilam University of Medical Sciences, Ilam, Iran Bahram Fadaei Dowlat bahram.fadaee82@gmail.com 200319475328460093429 0009-0007-6449-7502 No School of Medicine, Iran University of Medical Sciences, Tehran, Iran Iman Ghasemi imanghasemij@yahoo.com 200319475328460093430 0009-0004-6392-9308 No School of Medicine, Iran University of Medical Sciences, Tehran, Iran Seyyed Amir Yasin Ahmadi yasin_ahmadi73@yahoo.com 200319475328460093431 200319475328460093431 No Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran Shayan Amiri amiri.shayan23@gmail.com 200319475328460093432 200319475328460093432 Yes Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran