With the development of society and the aging of the population, the number of elderly patients with femoral neck fractures is gradually increasing. In order to reduce the complications caused by long-term bed rest, reduce the burden of care and improve the quality of life, artificial total hip replacement (ART) has been adopted in the treatment of femoral neck fractures in the elderly with good results, which is effective in improving joint function and relieving It is effective in improving joint function and relieving pain. To reduce the complications caused by long-term bed rest in elderly patients with femoral neck fracture, reduce the burden of family members and improve the quality of life of patients, artificial hip replacement was adopted. Methods: 104 patients with femoral neck fractures over 60 years of age were treated with total hip replacement through the posterior-lateral approach with adequate preoperative preparation, and the patients were followed up for 6 months to 5 years. The patients walked on the ground in about 2 weeks and basically recovered their pre-injury functions, with an excellent rate of 90%. Conclusion: 1. It is possible to perform total hip replacement surgery in elderly patients with good preoperative preparation; 2. Strengthen postoperative management to reduce complications; 3. Shorten treatment time; 4. Improve quality of life.