Many elderly patients with femoral neck fractures require artificial femoral head replacement, but some patients have poor postoperative results and still feel pain and other discomfort when walking. In order to achieve a good surgical result, the following tips need to be noted. 1. Surgical indications. For elderly patients with femoral neck fracture, as long as the physical condition allows, try to choose artificial total hip replacement. The advantages of femoral head replacement are short operation time, less bleeding, and suitable for patients of advanced age and poor physical condition. As for the age of total hip replacement and femoral head replacement, there are still controversies, some say 75 years old, some say 80 years old. Of course, we cannot judge purely on the basis of age, but mainly on the basis of physical condition. Relatively young patients with high activity levels choose artificial femoral head replacement, and the fake femoral head will cause wear and tear on the acetabular cartilage, and if the femoral head is too small, it may also wear the acetabulum through into the pelvis. There are also some patients who need revision of the artificial total hip replacement because of the pain after the femoral head replacement. Of course, there are some patients whose artificial femoral head has been used for 20 years and is still fine. 2, bone cement technology. Many patients have done femoral head replacement, because the bone cement technology is not up to date, the recent occurrence of loosening, sinking, and fracture after a fall, so it is necessary to standardize the bone cement technology. To use the third-generation bone cement technique, one of the most critical things to note is to use the distal femoral medullary cavity with a medullary plug, and to pay attention to the timing of the injection of bone cement, the proximal closure and pressure, and the time of prosthesis insertion, which of course requires experience. On postoperative radiographs, the technical X-ray grading of femoral bone cement (Barrack) can be divided into four grades. grade A: the femoral medullary cavity is completely filled with bone cement, and the cement-bone interface is white with no translucent bands (Figure 1); grade B: the cement-bone interface has slight translucent bands; grade C: the cement-bone interface has translucent bands within >50% or the cement sheath is partially defective; grade D: the cement-bone Grade A is the best and is the target of surgery, grade B is acceptable, and grade C and D should be avoided as much as possible. 3. The anterior inclination of the femoral prosthesis. Since the femoral head has a larger diameter and is not easily dislocated, the allowable error is larger, but if the anterior tilt angle of the femoral prosthesis is too large or too small, anterior dislocation or posterior dislocation can also occur. How to control the anterior tilt angle of the femoral prosthesis, many doctors may be unclear about this concept, here to emphasize. The calf is perpendicular to the ceiling in the posterior approach, and the calf is perpendicular to the ground in the lateral approach, so that the calf is perpendicular to the through condylar line, and then let the gaze, the center of the proximal femoral neck and the center of the femoral condyles become a three-point line, and observe the angle made between the axis of the femoral prosthesis and the horizontal plane, which is generally controlled at about 10 degrees (Figure 3). 4, the size of the artificial femoral head. After removing the femoral head, you should measure the diameter of the femoral head and choose the artificial femoral head that is closest to the diameter of the femoral head, too big or too small is not good. After paying attention to the above points, you will be able to make a perfect artificial femoral head replacement surgery.