Treatment of femoral neck fractures with prosthetic arthroplasty

Purpose of review: The incidence of femoral neck fractures continues to increase as the United States population ages. Controversy exists about the best form of treatment. Many authors agree that arthroplasty is the treatment of choice in elderly patients, whereas some continue to recommend internal fixation. This review focuses on the clinical outcomes of using hemiarthroplasty or total hip arthroplasty in the treatment of displaced femoral neck fractures. Recent findings: In reviews of some of the most recent literature, it has been shown that both hemiarthroplasty and total hip arthroplasty are successful treatment options for displaced femoral neck fractures in the elderly. In many patients treated with hemiarthroplasty, acetabluar erosion will develop, with an increased risk of persistent pain. For this reason, a trend toward treating younger, more active patients with total hip arthroplasty has emerged in recent articles. Summary: Overall health care in the United States continues to improve. For this reason, patients can be expected to live longer, more active lives. The durability of selected implants must be a consideration. Both hemiarthroplasty and total hip arthroplasty are commonly used for the treatment of displaced femoral neck fractures. Total hip arthroplasty may prove to be the best option for active patients to decrease the risk of acetabular erosion and the need for secondary surgical procedures. The authors hope that this review will help guide clinical decisions in treating displaced femoral neck fractures.