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Question 621

Topic: Biomechanics & Biomaterials

Which structural property is the primary determinant of torsional rigidity in a solid intramedullary nail?

. Nail length
. Wall thickness
. Radius to the fourth power
. Radius to the third power
. Material modulus of elasticity squared

Correct Answer & Explanation

. Nail length


Explanation

The torsional rigidity of a solid cylinder is proportional to its polar moment of inertia, which scales with the radius to the fourth power (r^4). Therefore, small increases in the diameter of an IM nail result in massive increases in torsional rigidity.

Question 622

Topic: Biomechanics & Biomaterials

A dynamic splint is applied to a patient's contracted elbow, delivering a constant force. Over several days, the joint progressively gains extension. Which biomechanical property of viscoelastic materials does this best describe?

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

Correct Answer & Explanation

. Stress relaxation


Explanation

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

Question 623

Topic: Biomechanics & Biomaterials

To minimize stress shielding in total joint arthroplasty, engineers seek materials that match the mechanical properties of bone. Which of the following implant materials has a modulus of elasticity closest to that of human cortical bone?

. Stainless steel
. Cobalt-chromium alloy
. Titanium alloy (Ti-6Al-4V)
. Alumina ceramic
. Polymethylmethacrylate (PMMA)

Correct Answer & Explanation

. Stainless steel


Explanation

Titanium alloy has a modulus of elasticity (approx. 110 GPa) that is closer to cortical bone (15-20 GPa) than stainless steel (200 GPa) or CoCr (210 GPa). This closer match reduces the extent of stress shielding.

Question 624

Topic: Biomechanics & Biomaterials

When a tendon is tested in tension, the initial region of its stress-strain curve demonstrates low stiffness before becoming linear. What is responsible for this initial 'toe region'?

. Microfailure of individual collagen fibers
. Uncrimping of the wavy collagen fibers
. Plastic deformation of the tendon matrix
. Viscoelastic creep under constant load
. Extrusion of water from the proteoglycan matrix

Correct Answer & Explanation

. Microfailure of individual collagen fibers


Explanation

The toe region corresponds to the initial uncrimping or straightening of the naturally wavy collagen fibers at low strains. Once the fibers are straight, the curve enters the linear (elastic) region.

Question 625

Topic: Biomechanics & Biomaterials

During cyclic loading of a tendon, a steady increase in deformation over time while the applied load remains strictly constant is best described by which viscoelastic property?

. Stress relaxation
. Creep
. Hysteresis
. Isotropic deformation
. Anisotropy

Correct Answer & Explanation

. Stress relaxation


Explanation

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

Question 626

Topic: Biomechanics & Biomaterials

Which of the following best describes the inherent mechanical behavior of cortical bone?

. Stronger in tension than in compression
. Stronger in shear than in compression
. Exhibits identical strength in all directions of loading
. Stronger in compression than in tension and shear
. Highly isotropic due to its crystalline hydroxyapatite structure

Correct Answer & Explanation

. Stronger in tension than in compression


Explanation

Cortical bone is highly anisotropic, meaning its mechanical properties vary depending on the direction of the applied load. It is strongest in compression, significantly weaker in tension, and weakest in shear.

Question 627

Topic: Biomechanics & Biomaterials

Which of the following physical properties accurately describes polymethylmethacrylate (PMMA) bone cement when utilized in arthroplasty?

. It acts as a biologic adhesive binding directly to hydroxyapatite
. It is notably stronger in tension than in compression
. It cures via an endothermic reaction allowing for immediate cooling
. It relies exclusively on mechanical interlock for implant stability
. Its modulus of elasticity is significantly greater than that of cortical bone

Correct Answer & Explanation

. It acts as a biologic adhesive binding directly to hydroxyapatite


Explanation

PMMA functions strictly as a grout, relying purely on macro- and micro-mechanical interlock with the surrounding cancellous bone and the implant, not as a chemical adhesive. It is strongest in compression, weakest in tension, and undergoes a highly exothermic curing process.

Question 628

Topic: Biomechanics & Biomaterials

On a classic stress-strain curve for a typical metallic implant, the exact point at which the material ceases to deform elastically and begins to deform permanently is known as the:

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

Correct Answer & Explanation

. Ultimate tensile strength


Explanation

The yield point marks the critical transition from elastic (fully reversible) deformation to plastic (irreversible) deformation on a stress-strain curve. The linear portion leading up to this point represents the material's modulus of elasticity.

Question 629

Topic: Biomechanics & Biomaterials

Regarding the modulus of elasticity (Young's modulus), which of the following sequences correctly orders common orthopedic materials from most stiff to least stiff?

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

Correct Answer & Explanation

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


Explanation

The modulus of elasticity is a measure of material stiffness. Cobalt-chromium is the stiffest (approx. 220 GPa), followed by stainless steel (200 GPa), titanium alloy (110 GPa), and finally cortical bone (15-20 GPa).

Question 630

Topic: Biomechanics & Biomaterials

Galvanic corrosion in orthopedic implants is most highly accelerated and likely to occur under which of the following specific conditions?

. A single titanium implant placed in a highly oxygenated tissue environment
. Mixed implantation of stainless steel and cobalt-chromium in a saline environment
. Implantation of ultra-high-molecular-weight polyethylene articulating with a ceramic head
. Implantation of two identical stainless steel plates side by side
. A well-fixed PMMA cemented cobalt-chromium stem

Correct Answer & Explanation

. A single titanium implant placed in a highly oxygenated tissue environment


Explanation

Galvanic corrosion requires two dissimilar metals with different anodic indices (such as stainless steel and cobalt-chromium) placed in electrical contact within an electrolytic solution (like physiologic saline). This electrochemical cell leads to accelerated corrosion of the less noble metal.

Question 631

Topic: Biomechanics & Biomaterials

On a standard stress-strain curve for an orthopedic biomaterial, the slope of the curve strictly within its linear elastic region represents which of the following material properties?

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

Correct Answer & Explanation

. Yield strength


Explanation

Young's modulus, a direct measure of a material's intrinsic stiffness, is defined as the slope of the stress-strain curve within its linear elastic region. Toughness, in contrast, represents the total energy absorbed before failure (total area under the curve).

Question 632

Topic: Biomechanics & Biomaterials
Increasing the radiation dose during the cross-linking process of ultra-high molecular weight polyethylene (UHMWPE) for total joint arthroplasty has what primary effect on its material properties?
. Increases volumetric wear
. Increases fatigue strength
. Decreases ductility
. Decreases oxidation resistance
. Increases yield strength

Correct Answer & Explanation

. Decreases ductility


Explanation

Increasing the radiation dose increases the density of cross-links, which significantly reduces the volumetric wear of the polyethylene. However, this process sacrifices mechanical properties, notably decreasing the material's ductility, fatigue strength, and fracture toughness.

Question 633

Topic: Biomechanics & Biomaterials

A patient undergoes an ACL reconstruction. When the graft is tensioned and secured at a constant fixed length, the tension within the graft is observed to gradually decrease over time. What is this specific viscoelastic property called?

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

Correct Answer & Explanation

. Creep


Explanation

Stress relaxation is the viscoelastic property where a tissue or material experiences a decrease in stress (tension) over time when held at a constant strain (length). In contrast, creep refers to continued deformation over time under a constant load.

Question 634

Topic: Biomechanics & Biomaterials

Trunnionosis in total hip arthroplasty, characterized by wear and localized failure at the modular head-neck junction, is primarily initiated by which specific type of corrosion?

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

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Trunnionosis is primarily driven by fretting corrosion, which occurs due to mechanical micromotion at the modular head-neck interface. This mechanical wear constantly strips the protective passive oxide layer, leading to severe electrochemical degradation.

Question 635

Topic: Biomechanics & Biomaterials

During a biomechanical evaluation of a normal human patellar tendon, the initial non-linear "toe region" of the stress-strain curve is observed. What physiological structural property is responsible for this phenomenon?

. Microfailure of collagen fibrils
. Uncrimping of type I collagen fibers
. Plastic deformation of the extracellular matrix
. Slippage of water and proteoglycans
. Rupture of cross-links between collagen molecules

Correct Answer & Explanation

. Microfailure of collagen fibrils


Explanation

The initial non-linear "toe region" on a stress-strain curve of a tendon or ligament represents the uncrimping or straightening of the relaxed, wavy type I collagen fibers. Once uncrimped, the curve becomes linear (elastic region) as the collagen fibers stretch.

Question 636

Topic: Biomechanics & Biomaterials

A viscoelastic material, such as a ligament, is subjected to a constant tensile load over an extended period, resulting in a gradual increase in length over time. This biomechanical property is defined as:

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

Correct Answer & Explanation

. Stress relaxation


Explanation

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

Question 637

Topic: Biomechanics & Biomaterials

A surgeon implants a stainless steel screw through a titanium plate. What type of corrosion is most likely to occur due to the mixing of these dissimilar metals in the body?

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

Correct Answer & Explanation

. Crevice corrosion


Explanation

Galvanic corrosion occurs when two electrochemically dissimilar metals are placed in direct contact within a conductive electrolyte, leading to accelerated corrosion of the less noble metal. Stainless steel and titanium should generally not be mixed to prevent this.

Question 638

Topic: Biomechanics & Biomaterials

A 60-year-old man presents with a swollen, painful knee. Arthrocentesis yields a synovial fluid with a white blood cell count of 45,000 cells/mcL with 85% polymorphonuclear leukocytes. Under polarized light microscopy, weakly positively birefringent rhomboid crystals are seen. What is the principal composition of these crystals?

. Monosodium urate
. Calcium pyrophosphate dihydrate
. Hydroxyapatite
. Calcium oxalate
. Cholesterol

Correct Answer & Explanation

. Monosodium urate


Explanation

The presentation describes pseudogout. Calcium pyrophosphate dihydrate (CPPD) crystals are characteristically rhomboid-shaped and exhibit weak positive birefringence under compensated polarized light microscopy.

Question 639

Topic: Biomechanics & Biomaterials

Polymethylmethacrylate (PMMA) bone cement is frequently used in arthroplasty. Which of the following statements best describes the mechanical properties and function of PMMA?

. It acts as an adhesive to bond the implant to the bone chemically
. It is stronger in tension than in compression
. It acts as a grout, providing mechanical interlock between the bone and implant
. Its elastic modulus is significantly higher than that of cortical bone
. Adding antibiotics increases its fatigue strength

Correct Answer & Explanation

. It acts as an adhesive to bond the implant to the bone chemically


Explanation

PMMA acts as a grout rather than a chemical adhesive, relying on mechanical interlock within the cancellous bone to secure the implant. PMMA is strong in compression but weak in tension and shear.

Question 640

Topic: Biomechanics & Biomaterials

Which of the following orthopedic biomaterials has a modulus of elasticity that is closest to that of human cortical bone?

. Stainless steel
. Cobalt-chromium alloy
. Titanium alloy
. Tantalum
. Polymethylmethacrylate (PMMA)

Correct Answer & Explanation

. Stainless steel


Explanation

Titanium alloy has a modulus of elasticity (approx. 110 GPa) that is much closer to cortical bone (15-20 GPa) than stainless steel (200 GPa) or cobalt-chromium (210 GPa). This closer biomechanical match helps reduce stress shielding around implants.