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Question 21

Topic: Biomechanics & Biomaterials

An orthopedic surgeon is planning to revise a fractured femoral stem but opts to retain a well-fixed cobalt-chromium modular head. If a new titanium alloy stem is implanted and mated with the existing cobalt-chromium head, what type of corrosion is theoretically most accelerated at this modular junction?

. Crevice corrosion
. Pitting corrosion
. Galvanic corrosion
. Fretting corrosion
. Intergranular corrosion

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Galvanic corrosion occurs when two dissimilar metals (such as titanium and cobalt-chromium) are in physical contact within an electrolytic solution (body fluid), creating a local electrochemical cell that accelerates corrosion of the less noble metal.

Question 22

Topic: Biomechanics & Biomaterials

Which of the following biomechanical terms best describes the progressive deformation of a viscoelastic material, such as articular cartilage, when subjected to a constant load over time?

. Stress relaxation
. Creep
. Hysteresis
. Fatigue failure
. Isotropic deformation

Correct Answer & Explanation

. Creep


Explanation

Creep is defined as the time-dependent, progressive deformation of a material under a constant load. Stress relaxation is the decrease in stress over time when a material is held at a constant strain.

Question 23

Topic: Biomechanics & Biomaterials

Failure of a modular total hip arthroplasty at the head-neck junction often involves crevice corrosion. Which of the following initiates this specific type of corrosion in orthopedic implants?

. Galvanic differences between identical metals
. Systemic depletion of circulating macrophages
. Localized depletion of oxygen within the crevice
. Mechanical fracture of the ceramic head
. Excessive production of highly alkaline synovial fluid

Correct Answer & Explanation

. Localized depletion of oxygen within the crevice


Explanation

Crevice corrosion is initiated by the localized depletion of oxygen within the fluid restricted inside the crevice. This creates an anodic, acidic environment compared to the oxygen-rich surface outside, driving metal dissolution.

Question 24

Topic: Biomechanics & Biomaterials

On a standard stress-strain curve representing the mechanical behavior of cortical bone, what does the slope of the linear elastic region represent?

. Yield strength
. Ultimate tensile strength
. Toughness
. Young's modulus of elasticity
. Viscoelasticity

Correct Answer & Explanation

. Young's modulus of elasticity


Explanation

The slope of the linear elastic region on a stress-strain curve represents Young's modulus of elasticity. This value denotes the intrinsic stiffness of the material.

Question 25

Topic: Biomechanics & Biomaterials

During anterior cruciate ligament reconstruction, the graft is tensioned and secured. Over time, the surgeon notes that the tension required to hold the graft at a constant length decreases. Which viscoelastic property does this phenomenon represent?

. Creep
. Stress relaxation
. Hysteresis
. Fatigue failure
. Anisotropy

Correct Answer & Explanation

. Stress relaxation


Explanation

Stress relaxation is a viscoelastic property where a material held at a constant length or strain experiences a gradual decrease in internal stress (and thus tension) over time.

Question 26

Topic: Biomechanics & Biomaterials

During a complex revision total hip arthroplasty, a surgeon utilizes a 316L stainless steel screw to secure a titanium alloy acetabular component. Which of the following complications is most likely to occur at the interface of these two metals?

. Fretting wear exclusively
. Abrasive wear of the titanium
. Galvanic corrosion
. Crevice corrosion of the titanium
. Cold welding

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Galvanic corrosion occurs when two macroscopic metals with different electrochemical potentials (e.g., stainless steel and titanium) are placed in direct contact within an electrolytic medium (body fluids), causing the less noble metal to corrode.

Question 27

Topic: Biomechanics & Biomaterials

A researcher is studying the mechanical properties of cortical bone. On a standard stress-strain curve representing the tensile testing of a bone specimen, what term defines the exact point where the material transitions from elastic deformation to permanent plastic deformation?

. Ultimate failure point
. Yield point
. Young's modulus
. Toe region
. Proportional limit

Correct Answer & Explanation

. Yield point


Explanation

The yield point marks the end of elastic (reversible) deformation and the beginning of plastic (irreversible) deformation on a stress-strain curve. Loading beyond this point results in permanent structural changes.

Question 28

Topic: Biomechanics & Biomaterials

A researcher is evaluating an orthopedic implant made of a titanium alloy. During mechanical testing, the material is loaded into its elastic range and held at a constant strain. Over time, the internal force within the material progressively decreases. What biomechanical phenomenon does this describe?

. Creep
. Stress relaxation
. Fatigue
. Hysteresis
. Isotropy

Correct Answer & Explanation

. Stress relaxation


Explanation

Stress relaxation is a viscoelastic property where the stress (internal force) decreases over time when a material is held at a constant strain (deformation). Creep, conversely, is an increase in strain under constant stress.

Question 29

Topic: Biomechanics & Biomaterials

A biomechanical evaluation of a new synthetic ligament reveals that the material becomes stiffer as the rate of applied tension increases. This time- and rate-dependent material behavior is best described as:

. Anisotropy
. Viscoelasticity
. Plasticity
. Creep
. Fatigue

Correct Answer & Explanation

. Viscoelasticity


Explanation

Viscoelastic materials exhibit time- and rate-dependent behavior, meaning their mechanical response (like stiffness) changes depending on how fast the load is applied. Normal ligaments and tendons are naturally viscoelastic.

Question 30

Topic: Biomechanics & Biomaterials

Galvanic corrosion is an electrochemical process that occurs when two dissimilar metals are placed in physical contact within a conductive fluid environment. Which of the following metal combinations is highly susceptible to this specific type of corrosion and generally avoided in orthopedics?

. Titanium alloy and commercially pure titanium
. Cobalt-chromium and ceramic
. Titanium alloy and stainless steel
. Stainless steel and highly cross-linked polyethylene
. Zirconium and ceramic

Correct Answer & Explanation

. Titanium alloy and commercially pure titanium


Explanation

Mixing titanium alloys with stainless steel implants (e.g., a stainless steel screw in a titanium plate) in a physiological environment creates a strong electrochemical gradient, leading to rapid galvanic corrosion and potential hardware failure.

Question 31

Topic: Biomechanics & Biomaterials

Articular cartilage is divided into distinct zones. Which of the following best describes the organization of collagen fibers in the superficial (tangential) zone?

. Oriented perpendicular to the joint surface to resist shear stress
. Oriented parallel to the joint surface to resist shear stress
. Oriented obliquely to resist compressive forces
. Randomly oriented to provide isotropic strength
. Arranged in a radial pattern to anchor cartilage to subchondral bone

Correct Answer & Explanation

. Oriented parallel to the joint surface to resist shear stress


Explanation

In the superficial zone, collagen fibers are packed tightly and oriented parallel to the articular surface. This arrangement is highly specialized to resist shear stresses and provide a low-friction gliding surface.

Question 32

Topic: Biomechanics & Biomaterials

Which of the following metallic orthopedic implant materials has a modulus of elasticity closest to that of cortical bone?

. Stainless steel
. Cobalt-chromium alloy
. Titanium alloy
. Alumina ceramic
. Solid Tantalum

Correct Answer & Explanation

. Titanium alloy


Explanation

Titanium alloy has a modulus of elasticity of approximately 110 GPa, which is closest to cortical bone (15-20 GPa) among standard solid implant metals. This reduces the effect of stress shielding compared to stiffer metals like cobalt-chromium (210 GPa) or stainless steel (200 GPa).

Question 33

Topic: Biomechanics & Biomaterials

Pediatric bone:

. Has a higher modulus of elasticity than adult bone.
. Has lower bending strength than adult bone.
. Has a short plastic phase on the load-deformation curve.
. Has periosteum, which is more prone to tear than adult periosteum.
. Is more mineralized than adult bone

Correct Answer & Explanation

. Has lower bending strength than adult bone.


Explanation

Pediatric bone has less mineral and more vascular channels than adult bone. This gives it a lower bending strength and lower modules of elasticity than adult bone.

Question 34

Topic: Biomechanics & Biomaterials

When analyzing the biomechanical properties of a tendon, it is noted that applying a constant load over a prolonged period causes the tendon to gradually elongate. This viscoelastic phenomenon is best described as:

. Stress relaxation
. Creep
. Hysteresis
. Fatigue failure
. Isotropic behavior

Correct Answer & Explanation

. Creep


Explanation

Creep is the time-dependent deformation or elongation of a viscoelastic material when it is subjected to a constant load. In contrast, stress relaxation is the decrease in internal stress over time when the material is held at a constant length or strain.

Question 35

Topic: Biomechanics & Biomaterials
In total joint arthroplasty, early ultra-high-molecular-weight polyethylene (UHMWPE) components failed due to rapid oxidative degradation. Which historical sterilization method was primarily responsible for introducing the free radicals causing this issue?
. Ethylene oxide gas
. Gamma irradiation in air
. Hydrogen peroxide gas plasma
. Autoclaving
. Electron beam irradiation in a vacuum

Correct Answer & Explanation

. Gamma irradiation in air


Explanation

Gamma irradiation in the presence of oxygen (air) creates free radicals that react with oxygen over time, leading to oxidative degradation, embrittlement, and accelerated wear of the polyethylene component.

Question 36

Topic: Biomechanics & Biomaterials
Highly cross-linked ultra-high-molecular-weight polyethylene (UHMWPE) is widely used in total hip arthroplasty to reduce volumetric wear. Which step in its manufacturing process significantly reduces the risk of in vivo oxidation but comes at the cost of decreasing the ultimate tensile strength?
. Gamma irradiation in an inert gas
. Remelting above the melting temperature
. Sub-melting annealing
. Vitamin E doping
. Ethylene oxide sterilization

Correct Answer & Explanation

. Remelting above the melting temperature


Explanation

Remelting highly cross-linked polyethylene eliminates free radicals, thereby preventing long-term oxidation and structural degradation. However, this thermal process decreases crystallinity, which reduces the material's ultimate tensile and yield strength.

Question 37

Topic: Biomechanics & Biomaterials

During viscoelastic testing of a tendon, a constant load is applied over time, resulting in progressive deformation (elongation) of the tissue. What is this biomechanical phenomenon called?

. Stress relaxation
. Creep
. Hysteresis
. Strain rate dependency
. Fatigue failure

Correct Answer & Explanation

. Creep


Explanation

Creep is the time-dependent elongation of a viscoelastic material under a constant load. Stress relaxation is the decrease in internal stress over time when the material is held at a constant length.

Question 38

Topic: Biomechanics & Biomaterials

A surgeon is considering using a stainless steel screw in combination with a titanium plate for fracture fixation. Which of the following best describes the primary risk associated with mixing these two metals?

. Fretting corrosion
. Galvanic corrosion
. Crevice corrosion
. Stress corrosion cracking
. Pitting corrosion

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Mixing two dissimilar metals with different electrochemical potentials in an electrolytic environment (like the body) leads to galvanic corrosion. The less noble metal will corrode at an accelerated rate, potentially leading to implant failure.

Question 39

Topic: Biomechanics & Biomaterials

Galvanic corrosion in orthopedic implants occurs when two dissimilar metals are placed in physical contact within a conductive fluid environment. Which of the following metal combinations carries the highest risk of significant galvanic corrosion?

. Titanium alloy and Cobalt-Chromium alloy
. Stainless steel and Titanium alloy
. Cobalt-Chromium alloy and Zirconium
. Tantalum and Titanium alloy
. Stainless steel and Cobalt-Chromium alloy

Correct Answer & Explanation

. Stainless steel and Cobalt-Chromium alloy


Explanation

Mixing stainless steel with titanium or cobalt-chromium alloys creates a strong galvanic cell due to significant differences in their electrochemical potentials. This combination is generally avoided in orthopedic surgery to prevent accelerated corrosion and subsequent implant failure.

Question 40

Topic: Biomechanics & Biomaterials

During surgical repair of a Zone II flexor digitorum profundus (FDP) laceration, which of the following pulleys is most critical to preserve or reconstruct to prevent bowstringing of the tendon?

. A1 and A3
. A2 and A4
. A3 and A5
. C1 and C2
. A1 and A5

Correct Answer & Explanation

. A2 and A4


Explanation

The A2 and A4 pulleys arise from the proximal and middle phalanges, respectively, and are the most mechanically important pulleys. Preserving or reconstructing them is critical to prevent bowstringing and ensure proper flexor tendon kinematics.