Journal of orthopaedic trauma
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Although there is little doubt that arthroplasty of one form or another is appropriate treatment for many patients with a displaced femoral neck fracture, there is ongoing controversy about the relative merits of different types of arthroplasty among specific groups of patients. In particular, total hip arthroplasty is infrequently recommended because of concerns about the perceived high initial cost, increased risk of dislocation, and the anticipated low functional demands and life expectancy of the typical hip fracture patient. When viewed in this traditional context, the merits of total hip arthroplasty are not believed to outweigh the risks, except in the rare instance of a patient with preexisting symptomatic hip arthritis that sustains a hip fracture. ⋯ Finally, recent advances in the design of THA components such as the introduction of improved bearing surfaces allowing the use of larger femoral heads, combined with improved surgical techniques, may be making THA safer and less prone to dislocation and other mechanical complications. The purpose of this paper is to review the recent literature regarding the results of total hip replacement in patients with a displaced fracture of the femoral neck. Total hip replacement may have a larger role in the treatment of displaced femoral neck fractures than it has in the past.