Ceramic on Metal Total Hip Replacement System Multi-Center,Investigational Device Exemption Clinical Trial

This investigational device study is a non-randomized, non-inferiority, multi-center,
historically controlled study. The primary objective will be evaluated at the primary
endpoint (24 months) by the primary efficacy and safety measures that define patient
success. The proportion of patient success will determine whether the primary objective has
been met (study success).

The investigational device will be compared to a historical control comprised of patients
from the TRANSCEND® Ceramic on Ceramic IDE study. This comparison will be made using all
primary and secondary measures. However, only primary measures will be used to determine
study success.

Inclusion Criteria:

1. Must be 18 years of age or older at the time of enrollment,

2. Patient is skeletally mature,

3. Evidence of a signed and dated informed consent document indicating that the patient
has been informed of all pertinent aspects of the study,

4. Patient agrees to comply with this protocol, including participating in required
follow-up visits at the investigational site and completing study questionnaires,
(i.e. patient's reasonable driving distance to assure study follow-up and completion)

5. Investigator determines patient is a suitable candidate for primary total hip
replacement,

6. Body Mass Index (BMI) of <40,

7. Preoperative Harris Hip Score (HHS) < 70 points as calculated on the Pre-screening
Qualification Form and verified by the Sponsor,

8. Have a diagnosis of degenerative joint disease of the hip.

Exclusion Criteria:

1. Previous total hip replacement, hemi-arthroplasty, or fusion on the ipsilateral side,

2. Patients with a previous Girdlestone procedure,

3. Patient has a known metal allergy to any component of the investigational device
(e.g.cobalt, chromium, titanium or ceramics),

4. Patient has had a total knee arthroplasty of either leg,

5. Patient has vascular insufficiency, muscular atrophy, or neuromuscular disease in the
affected limb (based on the Investigator's discretion),

6. Patients with congenital disorder or deformity not adequately addressed by hip
replacement or has sufficient anatomic variance or remodeling of the hip joint that
may place the patient at risk for mechanical failure or that requires a structural
bone graft (based on the Investigator's discretion),

7. Patients with severe instability or deformity of the ligaments or surrounding soft
tissues that would preclude stability of the implant (based on the Investigator's
discretion),

8. Patients with Charcot or neuropathic arthropathy, or neuromuscular disease or any
other condition that would interfere with patient self-assessment or pain, the
function or quality of life required for patient reported outcomes during the study
(based on the Investigator's discretion),

9. Patient, male or postmenopausal female, with a history of metabolic bone disease, as
defined by the following:

- Osteoporosis where the patient is currently taking prescription medications that
increase bone-mineral density (e.g. Fosamax, Didronel), or

- Patient was previously diagnosed with a metabolic bone disease (e.g. Paget's
disease or osteomalacia), or

- Patient has any other metabolic bone disease to a degree that the investigator
determines that a THR would be contraindicated,

10. Active malignancy,

11. Patient has an active infection (e.g. hepatitis, AIDS, ARC or is HIV positive)-
systemic or at the site of intended surgery,

12. Clinical diagnosis of renal insufficiency where renal function is abnormal and
incapable of sustaining essential bodily functions. (e.g. as reported by KRONOS lab
BUN, Creatinine and estimated glomerular filtration rate (GFR <15 mL/min/1.73 m2)

13. Currently participating in any investigational studies not related to this study's
preoperative or postoperative care,

14. Patient has a mental illness or belongs to a vulnerable population (e.g., is a
prisoner or a severe drug abuser, or is developmentally disabled) such that his or
her ability to provide informed consent or comply with follow-up requirements is
compromised,

15. Patient is pregnant or interested in becoming pregnant in the next 2 years, (Due to
the required x-rays for the study),

16. Other severe acute or chronic medical condition that may interfere with the
interpretation of the study results, in the judgment of the investigator, which would
make the patient inappropriate for entry into this study.