Background: Fracture neck of the femur (NOF) is one of the indications for Total Hip Replacement (THR). However, the practice is not the same throughout the world.

Aim: We compared the use of THR in the management of the fracture NOF using the annual reports of the National Joint Registries from various countries.

Material and Methods: We used the latest available on line annual report of seven national arthroplasty registries to ascertain the rate of use of THR for fractures of the neck of the femur. The registries from Australia, Canada, Norway, Sweden, and the UK gave a detailed breakup of the indications for THR in their reports.

Results: 11.9% of the all the THRs performed in Norway since 1987 were for NOFs. · 11.39% of all the THRs performed in Sweden since 1992 were for NOFs.

6.0% of the THRs performed in Canada in 2002–2003 were for NOFs.

The registries from Finland and New Zealand had no detailed information on their websites regarding the indications for THA surgery.

Discussion: In the Scandinavian countries, THR is performed for the management of a NOF 6 times more often than in the UK, and 4 times more often than in Australia. It is unlikely that the prevalence of patients with previous osteoarthritis of hip who sustain a NOF is higher in the Scandinavian countries than in the UK. Women in Sweden have a higher lifetime risk of hip fracture and live longer, so a procedure providing a good long term results would be beneficial. Provision of health care may also influence surgical management options. The long waiting lists for elective THR in the UK may explain the low number of THRs performed for NOFs.