Total hip replacement for elderly neck of femur fracture patients

In keeping with recently published national guidelines, the use of total hip replacement for treating displaced intracapsular hip fractures in elderly patients has significantly increased. This is based on the principle that it provides improved functional outcomes when compared to hemiarthroplasty. Whilst recent published evidence supports this hypothesis, there are concerns regarding higher dislocation rates, cost-effectiveness and difficulties with service provision. The aim of this review is to discuss the benefits of total hip replacement surgery over hemiarthroplasty and to explore patient selection criteria. A review of surgical techniques and difficulties specific to this patient cohort will also be presented. We hope to provide the reader with an up-to-date summary of total hip replacement surgery for hip fractures in elderly patients in order to help decision making, minimize complications and guide further research.