Arthroplasty: cemented stem for hemiarthroplasty: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Arthroplasty: cemented stem for hemiarthroplasty

Sample item

An 82-year-old woman with osteoporosis has a displaced intracapsular femoral neck fracture and is to receive a hemiarthroplasty. Which choice of stem fixation is generally preferred?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Cemented stem

In elderly patients with osteoporotic bone, a cemented femoral stem gives immediate stable fixation, less thigh pain and fewer periprosthetic fractures than an uncemented stem. Cement carries a small risk of bone cement implantation syndrome, which the anaesthetist must anticipate. Uncemented stems are favoured in younger patients with good bone stock.

Option by option

  • A. Uncemented stem always

    Uncemented stems carry more periprosthetic fracture and pain in osteoporotic bone.

  • B. Screw fixation only

    Screws are used for undisplaced fractures or young patients, not for this displaced fracture in an elderly patient.

  • C. Cemented stem (correct)

    Correct. Cemented stems are preferred in elderly osteoporotic patients.

  • D. Girdlestone excision

    Girdlestone excision is a salvage procedure and not a primary treatment.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Cemented stem. In elderly patients with osteoporotic bone, a cemented femoral stem gives immediate stable fixation, less thigh pain and fewer periprosthetic fractures than an uncemented stem.

Why is "Uncemented stem always" not the answer?

Uncemented stems carry more periprosthetic fracture and pain in osteoporotic bone.

Why is "Screw fixation only" not the answer?

Screws are used for undisplaced fractures or young patients, not for this displaced fracture in an elderly patient.

Why is "Girdlestone excision" not the answer?

Girdlestone excision is a salvage procedure and not a primary treatment.

What concept does this question test?

It tests Arthroplasty: cemented stem for hemiarthroplasty in Orthopaedics. Cement carries a small risk of bone cement implantation syndrome, which the anaesthetist must anticipate. Uncemented stems are favoured in younger patients with good bone stock.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Arthroplasty: cemented stem for hemiarthroplasty?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.