Park CW, et al. - Between April 2000 and March 2002, 167 candidates were estimated to assess the 15-year outcomes of cementless total hip arthroplasty (THA) using a 28-mm Ultima metal-on-metal (MoM) articulation. An improvement in the mean Harris Hip Scores from 44.9 points preoperatively to 90.5 points during the last follow-up. A total of 5 revisions (3.8%) was found correlated with an adverse reaction to metal debris (ARMD) during the entire period since the original surgery. They noted implant survivorships with an end point of revision for aseptic failure and for any reason, 95.4%, and 93.8%, respectively. They observed radiographic osteolytic lesions in 27 hips. For cobalt and chromium, they recorded the average serum metal concentration of 2.50 μg/L and 2.81 μg/L, respectively. Overall, they reported favorable long-term outcomes with a relatively high revision-free survival rate in THA with the utilization of a 28-mm MoM articulation.