Many elderly patients with femoral neck fractures and their families are often confused as to whether they should choose joint replacement or nailing and internal fixation. Sometimes, when they consult different doctors, they will have different recommendations of nailing and internal fixation and joint replacement. In fact, this issue has been controversial among orthopedic trauma and joint surgery doctors for a long time, and the focus of the controversy comes from the service life of the artificial joint. If the artificial joint has a long enough service life, such as 30 or 40 years or more, then patients over 55 years old can choose joint replacement. With the development of material science, engineers in the field of joints worldwide have focused more on the improvement of the friction interface of artificial joints. The metal-polyethylene interface of the 1980s and 1990s had a wear of about 0.1mm per year and a service life of about 15-20 years; the ceramic-ceramic interface that has emerged in the last decade or so, especially the fourth generation of ceramics, has extremely slight wear of less than 0.01mm per year, which makes the service life of artificial joints much higher, but of course this is only possible with skilled technology in the first place to ensure such an effect. If the technology is not up to par and the installation standards are not met, even the best joint will not have good results. Therefore, if patients with femoral neck over 55 years old choose professional joint surgeons and wear-resistant ceramic interface, it is possible to directly choose artificial joint replacement. Of course, we recommend internal fixation for femoral neck patients under 55 years old.