Kuijpers MFL, et al. - All patients younger than 55 years with a primary THA implanted in the Netherlands between 2007 and 2017 were chosen (n = 19,682) by the researchers to examine the impact of both patient-related and surgical factors on the risk of revision using data from the Dutch Arthroplasty Registry (LROI). Of primary THA, the overall 5-year survival was 95.3%. The use of the anterior approach led to a lower risk of revision in comparison with the use of the posterolateral approach. THAs with a head diameter ≥ 38 mm had a greater risk of revision than THAs with 32 mm heads. The use of metal-on-metal (MoM) bearings led to an increased risk in comparison with C-PE. In conclusion, in patients younger than 55 years, the risk of revision depends on the surgical approach, head size, and bearing type. The anterior approach led to a reduced risk of revision, whereas the use of ≥ 38 mm heads and MoM bearings led to an elevated risk of revision for any reason.