Variability in the approach to total hip arthroplasty in patients with displaced femoral neck fractures.

The aim of this study was to determine the degree of variability in implants, approaches, and associated complication rates in randomized controlled trials (RCTs) evaluating primary total hip arthroplasty (THA) as an intervention for displaced femoral neck fractures. We searched 2 medical databases for RCTs involving THA for femoral neck fractures published between June 2000 and June 2010. All analyses were descriptive. Nine RCTs met our inclusion criteria. We identified variability in both the surgical approach and choice of prosthesis. Trials generally standardized to head sizes of 28 mm or greater and cemented prostheses. Surgical experience varied across studies. Dislocation rates varied from 0% to 22%. There is considerable variability in RCTs evaluating THA for femoral neck fractures. Standardization toward optimal outcomes for femoral neck fractures is needed.