Data from 19 RCTs (3505 patients) was pooled and analyzed to determine if arthroplasty or internal fixation is a better treatment method for displaced femoral neck fractures in patients 60 years of age or older. The evidence indicated that arthroplasty presented substantially reduced rates of surgical revision, and fewer serious, method-related complications when compared to internal fixation. Mortality rates were similar between both procedures. Further research examining specific types of arthroplasty is warranted to further ascertain the optimal treatment for displaced femoral neck fractures in the elderly.