The study analysed data from 372,967 primary total hip arthroplasties in UK patients from 2010 to 2020, with a median follow-up of 5.39 years. A total of 8,043 major reoperations, defined as first revision for any cause or fixation of postoperative periprosthetic femur fractures, were identified. The incidence of reoperations was 3.78% (95% CI 3.70-3.86%) per 1,000 prosthesis-years, versus 3.00% (95% CI 2.93-3.07%) when only revisions were considered. The cumulative incidence after 10 years was 3.1% (95% CI 3.0-3.1%). In men older than 68 years, cementless collared strains had a lower rate of reoperation than cemented strains. In women older than 75 years, the best results were with cemented polished stainless steel tapered shanks. The study recommends re-evaluation of implant guidelines in older patients and is a retrospective level III evidence cohort study.