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Question 541

Topic: Biomechanics & Biomaterials

The progressive deformation of a polyethylene tibial insert over time under a constant static load is an example of which biomechanical principle?

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

Correct Answer & Explanation

. Creep


Explanation

Creep is the progressive deformation of a viscoelastic material when subjected to a constant, continuous stress over time. Stress relaxation, conversely, is the decrease in stress over time when a material is held at a constant strain.

Question 542

Topic: Biomechanics & Biomaterials

When adding antibiotics to polymethylmethacrylate (PMMA) bone cement, which of the following characteristics is essential for the antibiotic to be effective?

. High molecular weight
. Heat stability
. Hydrophobic nature
. Bacteriostatic mechanism
. Narrow spectrum of activity

Correct Answer & Explanation

. Heat stability


Explanation

PMMA polymerization is an exothermic reaction that can reach temperatures exceeding 80 degrees Celsius. Therefore, any antibiotic mixed into the cement (such as tobramycin or vancomycin) must be heat stable to maintain its antimicrobial efficacy.

Question 543

Topic: Biomechanics & Biomaterials

A viscoelastic orthopedic implant is subjected to a constant, sustained load over several years, resulting in a slow, progressive deformation of the material. This biomechanical phenomenon is best described as:

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

Correct Answer & Explanation

. Creep


Explanation

Creep is the progressive deformation of a viscoelastic material when subjected to a constant load over time. In contrast, stress relaxation is a decrease in stress over time when the material is held at a constant deformation.

Question 544

Topic: Biomechanics & Biomaterials

Combining a 316L stainless steel screw with a titanium alloy plate in a fracture construct increases the risk of implant failure due to which specific type of corrosion?

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

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Galvanic corrosion occurs when two dissimilar metals with different electrochemical potentials are placed in contact within an electrolytic environment (like body fluid). The less noble metal undergoes accelerated corrosion.

Question 545

Topic: Biomechanics & Biomaterials
Highly cross-linked ultra-high-molecular-weight polyethylene (UHMWPE) is routinely used in total hip arthroplasty to reduce volumetric wear. What is the primary biomechanical tradeoff resulting from the irradiation and thermal treatment processes used to create it?
. Increased oxidation potential in vivo
. Decreased fatigue strength and fracture toughness
. Decreased modulus of elasticity
. Increased adhesive wear
. Decreased ultimate compressive strength

Correct Answer & Explanation

. Decreased fatigue strength and fracture toughness


Explanation

While high cross-linking drastically improves wear resistance, the requisite irradiation and subsequent remelting/annealing alter the crystalline structure. This leads to reduced fatigue strength, yield strength, and fracture toughness, making the material more susceptible to catastrophic failure under certain stresses.

Question 546

Topic: Biomechanics & Biomaterials

When incorporating an antibiotic into polymethylmethacrylate (PMMA) bone cement for an infected arthroplasty spacer, which specific property of the antimicrobial agent is most vital to ensure it remains active after the cement cures?

. High molecular weight
. Bacteriostatic action
. Hydrophilicity
. Thermostability
. Short biological half-life

Correct Answer & Explanation

. Thermostability


Explanation

The curing of PMMA is a highly exothermic reaction that can reach temperatures exceeding 80 degrees Celsius. Therefore, any antibiotic mixed into the cement (such as vancomycin or tobramycin) must be thermostable to retain its bactericidal efficacy.

Question 547

Topic: Biomechanics & Biomaterials

When applying a locked plate to a highly comminuted diaphyseal fracture, what is its primary biomechanical advantage over a standard, non-locked dynamic compression plate?

. It promotes primary bone healing by generating interfragmentary compression
. It requires exact anatomical contouring to the bone surface to maintain alignment
. It functions as a fixed-angle construct that does not rely on plate-to-bone friction
. It utilizes thicker screw core diameters to prevent galvanic corrosion
. It guarantees absolute stability across the entire fracture zone

Correct Answer & Explanation

. It functions as a fixed-angle construct that does not rely on plate-to-bone friction


Explanation

Locked plating systems utilize threaded screw heads that lock directly into the plate, creating a rigid fixed-angle construct. This relies on the angular stability of the screw-plate interface rather than friction between the plate and the underlying bone, preserving periosteal blood supply.

Question 548

Topic: Biomechanics & Biomaterials

Stress shielding around a femoral stem is primarily caused by a mismatch in stiffness between the implant and the surrounding bone. Which of the following sequences represents the correct order of Young's modulus of elasticity from greatest to least?

. Cobalt-chromium > Stainless steel > Titanium alloy > Cortical bone
. Stainless steel > Cobalt-chromium > Cortical bone > Titanium alloy
. Titanium alloy > Cobalt-chromium > Stainless steel > Cortical bone
. Cobalt-chromium > Titanium alloy > Stainless steel > Cortical bone
. Stainless steel > Titanium alloy > Cobalt-chromium > Cortical bone

Correct Answer & Explanation

. Cobalt-chromium > Stainless steel > Titanium alloy > Cortical bone


Explanation

Young's modulus is a measure of material stiffness. Cobalt-chromium is the stiffest (~220 GPa), followed by stainless steel (~200 GPa), titanium alloy (~110 GPa), and cortical bone (~15-20 GPa). Using materials closer to bone's modulus minimizes stress shielding.

Question 549

Topic: Biomechanics & Biomaterials

A patellar tendon graft is used for ACL reconstruction and is tensioned on the back table. Over time, while held at a constant tension, the graft gradually elongates. Which biomechanical property does this describe?

. Stress relaxation
. Creep
. Hysteresis
. Isotropy
. Fatigue failure

Correct Answer & Explanation

. Creep


Explanation

Creep is the progressive deformation (elongation) of a viscoelastic material when subjected to a constant load or tension over time. Stress relaxation, conversely, is the decrease in stress over time when the material is held at a constant length.

Question 550

Topic: Biomechanics & Biomaterials
Highly cross-linked ultra-high-molecular-weight polyethylene (UHMWPE) was developed to improve the longevity of total hip arthroplasty (THA). The primary advantage of cross-linking is the reduction of which type of wear?
. Fatigue wear
. Abrasive and adhesive wear
. Corrosive wear
. Third-body wear
. Galvanic wear

Correct Answer & Explanation

. Abrasive and adhesive wear


Explanation

Cross-linking UHMWPE significantly increases its resistance to adhesive and abrasive wear, which are the main modes of wear generating osteolytic particles in THA. However, highly cross-linked polyethylene has reduced mechanical properties, making it more susceptible to fatigue wear.

Question 551

Topic: Biomechanics & Biomaterials

Mixing stainless steel and titanium implants within the same surgical construct can lead to galvanic corrosion. In this scenario, what happens to the stainless steel component?

. It acts as the cathode and undergoes rapid oxidation
. It acts as the anode and undergoes accelerated corrosion
. It forms a protective passivation layer of chromium oxide
. It undergoes fretting wear but not electrochemical corrosion
. It transfers electrons directly to the titanium, preventing ion release

Correct Answer & Explanation

. It acts as the anode and undergoes accelerated corrosion


Explanation

In a galvanic couple between stainless steel and titanium, titanium is more noble (cathodic) and stainless steel is less noble (anodic). The anodic stainless steel will preferentially lose electrons and undergo accelerated corrosion.

Question 552

Topic: Biomechanics & Biomaterials

A researcher is studying the mechanical properties of different orthopedic materials compared to human cortical bone. Which of the following implant materials possesses a Young's modulus (modulus of elasticity) that is closest to that of cortical bone?

. Cobalt-chromium alloy
. 316L Stainless steel
. Titanium alloy (Ti-6Al-4V)
. Tantalum
. Alumina ceramic

Correct Answer & Explanation

. Titanium alloy (Ti-6Al-4V)


Explanation

Cortical bone has a Young's modulus of roughly 15-20 GPa. Titanium alloys have a modulus of around 100-110 GPa, which is much closer to cortical bone than stainless steel (approx. 200 GPa) or cobalt-chromium (approx. 240 GPa), reducing the risk of stress shielding.

Question 553

Topic: Biomechanics & Biomaterials

During an anterior cruciate ligament reconstruction, the surgeon pulls the soft-tissue graft under a constant load for several minutes before final fixation. The graft gradually lengthens during this period. Which viscoelastic property does this demonstrate?

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

Correct Answer & Explanation

. Creep


Explanation

Creep is the progressive deformation (lengthening) of a viscoelastic material when it is subjected to a constant load over time. Conversely, stress relaxation is the decrease in stress over time when a material is held at a constant length.

Question 554

Topic: Biomechanics & Biomaterials

A patient presents with a symptomatic nonunion of a femoral shaft fracture initially treated with a stainless steel plate. The surgeon plans to revise the fixation using a titanium plate and the existing stainless steel screws. Why is this construct contraindicated?

. Decreased fatigue strength of the titanium plate
. Risk of galvanic corrosion
. Titanium induces osteolysis when mixed with steel
. Fretting corrosion is eliminated
. Crevice corrosion only affects titanium implants

Correct Answer & Explanation

. Risk of galvanic corrosion


Explanation

Galvanic corrosion occurs when two dissimilar metals are in contact within a conductive physiological fluid, creating an electrochemical gradient. The less noble metal acts as an anode and undergoes accelerated corrosion, making the mixing of stainless steel and titanium implants contraindicated.

Question 555

Topic: Biomechanics & Biomaterials

When preparing antibiotic-loaded polymethylmethacrylate (PMMA) bone cement for a two-stage revision of an infected total hip arthroplasty, which of the following antibiotics is best suited for incorporation due to its thermal stability and elution profile?

. Ceftriaxone
. Tobramycin
. Penicillin G
. Ampicillin
. Tetracycline

Correct Answer & Explanation

. Tobramycin


Explanation

Antibiotics mixed into PMMA must be heat-stable to withstand the extreme exothermic polymerization reaction of the cement and must be available in powder form. Aminoglycosides (like tobramycin and gentamicin) and vancomycin meet these criteria and are most commonly used.

Question 556

Topic: Biomechanics & Biomaterials

In a standard stress-strain curve for a metallic orthopedic implant, what does the slope of the curve in the linear elastic region represent?

. Yield strength
. Ultimate tensile strength
. Toughness
. Young's modulus
. Ductility

Correct Answer & Explanation

. Young's modulus


Explanation

Young's modulus (the elastic modulus) measures a material's intrinsic stiffness and is defined as the slope of the stress-strain curve in the linear elastic region. Toughness is represented by the total area under the curve, and yield strength is the point where plastic deformation begins.

Question 557

Topic: Biomechanics & Biomaterials

During an ACL reconstruction, a hamstring tendon graft is tensioned and secured at a constant length. Over the first few minutes, the tension within the graft decreases. This viscoelastic phenomenon is known as:

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

Correct Answer & Explanation

. Stress relaxation


Explanation

Stress relaxation is the decrease in stress (tension) over time when a viscoelastic material is held at a constant length. Creep, conversely, is increasing deformation over time under a constant load.

Question 558

Topic: Biomechanics & Biomaterials

On a standard stress-strain curve for a structural material such as metal or bone, the point at which the material transitions from completely reversible elastic deformation to permanent plastic deformation is known as the:

. Ultimate tensile strength
. Yield point
. Failure point
. Proportional limit
. Modulus of elasticity

Correct Answer & Explanation

. Yield point


Explanation

The yield point marks the end of the linear elastic region. Loading a material past this specific point results in plastic, permanent deformation that will not recover upon load removal.

Question 559

Topic: Biomechanics & Biomaterials
Highly cross-linked polyethylene (HXLPE) is heavily utilized to decrease wear rates in total hip arthroplasty. What is the primary mechanical trade-off or consequence of increasing the cross-linking density in UHMWPE?
. Increased oxidation potential
. Decreased ductility and fracture toughness
. Decreased ultimate tensile strength
. Increased adhesive wear
. Decreased elastic modulus

Correct Answer & Explanation

. Decreased ductility and fracture toughness


Explanation

While cross-linking significantly improves wear resistance, it reduces the material's ductility, yield strength, and fracture toughness. This trade-off makes the polyethylene more susceptible to fatigue-related failure.

Question 560

Topic: Biomechanics & Biomaterials

Galvanic corrosion occurs when two dissimilar metals are in contact within a conductive fluid environment. Which factor primarily dictates the severity and direction of this corrosive process?

. The difference in electrochemical potential between the two metals
. The exact pH of the surrounding synovial fluid
. The physical surface roughness of the implants
. The presence of macrophages at the interface
. The overall mass of the two metals combined

Correct Answer & Explanation

. The difference in electrochemical potential between the two metals


Explanation

Galvanic corrosion requires an electrolyte fluid and two metals with differing electrochemical potentials. The less noble (more anodic) metal undergoes accelerated dissolution while the more noble metal is protected.