Hip: core decompression: 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 · Hip: core decompression

Sample item

A 32-year-old man on long-term corticosteroids has groin pain. MRI shows necrosis of the femoral head with an intact articular surface and no collapse. Which joint-preserving procedure is most appropriate?

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

The answer and the reasoning

A. Core decompression with or without bone grafting

Before the head collapses, core decompression lowers intraosseous pressure and may delay progression, and it can be combined with grafting. After collapse, joint-preserving options fail and arthroplasty is used. The choice depends on lesion size and stage of collapse.

Option by option

  • A. Core decompression with or without bone grafting (correct)

    Correct. Core decompression suits pre-collapse necrosis in young patients.

  • B. Total hip arthroplasty

    Arthroplasty is for collapsed heads with advanced arthritis.

  • C. Girdlestone excision arthroplasty

    Girdlestone excision is a salvage procedure for infection or failed replacement.

  • D. Hip arthrodesis

    Arthrodesis is a rare salvage procedure and is not first-line here.

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 A, Core decompression with or without bone grafting. Before the head collapses, core decompression lowers intraosseous pressure and may delay progression, and it can be combined with grafting.

Why is "Total hip arthroplasty" not the answer?

Arthroplasty is for collapsed heads with advanced arthritis.

Why is "Girdlestone excision arthroplasty" not the answer?

Girdlestone excision is a salvage procedure for infection or failed replacement.

Why is "Hip arthrodesis" not the answer?

Arthrodesis is a rare salvage procedure and is not first-line here.

What concept does this question test?

It tests Hip: core decompression in Orthopaedics. After collapse, joint-preserving options fail and arthroplasty is used. The choice depends on lesion size and stage of collapse.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Hip: core decompression?

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.