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Question 741

Topic: Biomechanics & Biomaterials

An orthopedic surgeon is meticulously contouring a reconstruction plate for a complex pelvic ring injury. Which of the following implant materials is most notoriously susceptible to fatigue failure if deeply scratched or notched during bending?

. 316L Stainless steel
. Titanium alloy (Ti-6Al-4V)
. Cobalt-chromium-molybdenum alloy
. Tantalum
. Commercially pure titanium

Correct Answer & Explanation

. 316L Stainless steel


Explanation

Titanium alloy (Ti-6Al-4V) is highly notch sensitive compared to stainless steel. Surface scratches or sharp bends create significant stress risers that drastically reduce its fatigue life, making it prone to sudden mechanical failure in load-bearing applications.

Question 742

Topic: Biomechanics & Biomaterials

Which of the following best describes the phenomenon of stress relaxation in a viscoelastic material such as a tendon?

. Continued deformation over time under a constant load
. Decrease in stress over time when held at a constant strain
. Increased stiffness at higher strain rates
. Loss of energy during a loading and unloading cycle
. Failure of the material under cyclical loading below its yield strength

Correct Answer & Explanation

. Continued deformation over time under a constant load


Explanation

Stress relaxation is the decrease in internal stress over time when a viscoelastic material is held at a constant strain. Creep is continued deformation under a constant load.

Question 743

Topic: Biomechanics & Biomaterials

Which of the following orthopaedic biomaterials has a Young's modulus closest to that of human cortical bone?

. Stainless steel
. Cobalt-chromium alloy
. Titanium alloy
. Polymethylmethacrylate (PMMA)
. Ultra-high-molecular-weight polyethylene (UHMWPE)

Correct Answer & Explanation

. Stainless steel


Explanation

Titanium alloy has a Young's modulus (approx. 110 GPa) closer to cortical bone (approx. 15-20 GPa) compared to Cobalt-chromium or Stainless steel. This reduces stress shielding of the host bone.

Question 744

Topic: Biomechanics & Biomaterials

Highly cross-linked ultra-high-molecular-weight polyethylene (UHMWPE) was developed primarily to address which of the following issues in total hip arthroplasty?

. Catastrophic fracture of the liner
. Squeaking during normal gait
. Adhesive and abrasive wear
. Fretting corrosion at the trunnion
. Impingement and early dislocation

Correct Answer & Explanation

. Catastrophic fracture of the liner


Explanation

Highly cross-linked polyethylene was developed to improve wear resistance against adhesive and abrasive wear. However, the cross-linking process decreases the material's fatigue strength and ductility.

Question 745

Topic: Biomechanics & Biomaterials

Galvanic corrosion in orthopaedic implants is most likely to occur under which of the following circumstances?

. A titanium screw is used to secure a titanium plate.
. A stainless steel screw is used through a cobalt-chromium plate.
. A titanium screw is inserted into severely osteoporotic bone.
. A cobalt-chromium femoral head is placed on a cobalt-chromium stem.
. Repeated micro-motion occurs between a screw and a plate of the same material.

Correct Answer & Explanation

. A titanium screw is used to secure a titanium plate.


Explanation

Galvanic corrosion occurs when two dissimilar metals are in direct contact within a conductive fluid environment. Mixing stainless steel with cobalt-chromium creates a strong galvanic couple, accelerating corrosion.

Question 746

Topic: Biomechanics & Biomaterials

Which of the following statements regarding the properties of polymethylmethacrylate (PMMA) bone cement is true?

. It provides rigid biologic fixation via osteointegration.
. Its curing process is a highly endothermic reaction.
. It is weakest in compression and strongest in tension.
. The addition of barium sulfate provides radiopacity but acts as a stress riser.
. Pre-cooling the monomer accelerates the polymerization time.

Correct Answer & Explanation

. It provides rigid biologic fixation via osteointegration.


Explanation

PMMA provides purely mechanical interlock rather than biologic fixation, and sets via an exothermic reaction. Additives like barium sulfate or zirconium dioxide act as stress risers, decreasing the cement's overall fatigue strength.

Question 747

Topic: Biomechanics & Biomaterials

Compared to conventional ultra-high-molecular-weight polyethylene (UHMWPE), highly cross-linked polyethylene used in total joint arthroplasty exhibits which of the following mechanical properties?

. Increased wear rate
. Increased fatigue crack propagation resistance
. Decreased fracture toughness
. Increased ultimate tensile strength
. Increased yield strength

Correct Answer & Explanation

. Increased wear rate


Explanation

Highly cross-linked polyethylene (HXLPE) significantly reduces volumetric wear compared to conventional UHMWPE. However, the cross-linking process and subsequent thermal treatment decrease its fracture toughness, fatigue crack propagation resistance, and ultimate tensile strength.

Question 748

Topic: Biomechanics & Biomaterials

During material testing, a specimen undergoes a stress-strain analysis. The total area under the stress-strain curve up to the point of failure represents which of the following material properties?

. Elastic modulus
. Yield strength
. Toughness
. Ductility
. Ultimate tensile strength

Correct Answer & Explanation

. Elastic modulus


Explanation

Toughness is defined as the amount of energy a material can absorb before failure, represented by the total area under the stress-strain curve. Modulus of elasticity is the slope of the elastic region, while ductility refers to the amount of plastic deformation before fracture.

Question 749

Topic: Biomechanics & Biomaterials

Which of the following orthopedic implant materials possesses a modulus of elasticity most closely resembling that of human cortical bone?

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

Correct Answer & Explanation

. Cobalt-chromium-molybdenum alloy


Explanation

Titanium alloys have a modulus of elasticity (roughly 110 GPa) that is closer to human cortical bone (15-20 GPa) than stainless steel (200 GPa) or cobalt-chrome (210 GPa). This closer match reduces stress shielding at the bone-implant interface.

Question 750

Topic: Biomechanics & Biomaterials

A patient undergoes revision of a metal-on-polyethylene total hip arthroplasty due to a grossly loose femoral stem. Intraoperatively, black debris and pitting are noted specifically at the modular head-neck junction.

What is the primary mechanism of this degradation?

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

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Fretting corrosion occurs at the contact sites of modular junctions (like the head-neck taper) due to micromotion under load, which repeatedly disrupts the passive oxide layer. This exposes fresh metal to the corrosive fluid environment, often exacerbated by crevice corrosion mechanisms.

Question 751

Topic: Biomechanics & Biomaterials

Polymethylmethacrylate (PMMA) bone cement is primarily utilized in total joint arthroplasty for implant fixation. Biomechanically, PMMA exhibits its greatest strength against which of the following forces?

. Tension
. Compression
. Shear
. Torsion
. Bending

Correct Answer & Explanation

. Tension


Explanation

PMMA bone cement functions primarily as a grout, not an adhesive, and is strongest in compression. It is significantly weaker in tension and shear, which is why component designs emphasize transmitting compressive loads to the cement mantle.

Question 752

Topic: Biomechanics & Biomaterials

During the clinical Lachman test, rapid translation of the tibia produces a stiffer response from the anterior cruciate ligament (ACL) than slow translation. This load-rate dependent behavior is characteristic of which material property?

. Isotropy
. Plasticity
. Viscoelasticity
. Fatigue
. Creep

Correct Answer & Explanation

. Isotropy


Explanation

Viscoelastic materials, such as ligaments and tendons, exhibit time- and rate-dependent mechanical properties. Their stiffness increases with a higher rate of loading (strain rate dependence), which helps protect the joint during dynamic, high-speed activities.

Question 753

Topic: Biomechanics & Biomaterials

Using a titanium screw through a 316L stainless steel plate in an aqueous physiologic environment increases the risk of which type of corrosion?

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

Correct Answer & Explanation

. Fretting corrosion


Explanation

Galvanic corrosion occurs when two dissimilar metals are placed in physical contact within a conductive electrolytic fluid (like blood or interstitial fluid). The difference in their electrochemical potentials drives an electron transfer, accelerating the corrosion of the less noble metal.

Question 754

Topic: Biomechanics & Biomaterials

To reduce oxidative degradation of conventional UHMWPE after sterilization with gamma irradiation, modern manufacturing processes incorporate a thermal treatment known as remelting. What is the primary negative biomechanical consequence of this remelting process?

. Increased free radical formation
. Decreased fatigue strength and toughness
. Increased volumetric wear
. Increased oxidative potential
. Decreased degree of cross-linking

Correct Answer & Explanation

. Increased free radical formation


Explanation

Remelting UHMWPE above its melting point extinguishes residual free radicals trapped in the crystalline regions, preventing future oxidation. However, it decreases the crystallinity of the polymer, leading to reduced mechanical properties such as fatigue strength and fracture toughness.

Question 755

Topic: Biomechanics & Biomaterials

A 65-year-old active man undergoes a total hip arthroplasty using highly cross-linked polyethylene (HXLPE). While this material significantly reduces wear, the cross-linking and subsequent thermal melting processes reduce which of the following mechanical properties, predisposing thin components to failure?

. Yield strength
. Fracture toughness
. Hardness
. Modulus of elasticity
. Ultimate tensile strength

Correct Answer & Explanation

. Yield strength


Explanation

Highly cross-linking polyethylene involves irradiation to improve wear resistance, followed by thermal melting to eliminate free radicals. This process significantly decreases the material's fatigue resistance and fracture toughness.

Question 756

Topic: Biomechanics & Biomaterials

To maximize the pullout strength of a cortical screw used in a diaphyseal fracture, which of the following design modifications is most effective?

. Decreasing the major diameter
. Increasing the minor diameter
. Decreasing the thread pitch
. Increasing the insertion torque past the yield point
. Decreasing the length of engagement

Correct Answer & Explanation

. Decreasing the major diameter


Explanation

Screw pullout strength is directly proportional to the outer (major) diameter, length of engagement, and volume of bone captured between threads. Decreasing the thread pitch increases the number of threads engaged per unit length, thereby increasing pullout strength.

Question 757

Topic: Biomechanics & Biomaterials

A 60-year-old patient presents with a painful total hip arthroplasty 5 years after the index procedure. Aspiration is negative for infection. Revision surgery reveals black debris and macroscopic damage at the modular head-neck taper junction. Which type of corrosion is most likely responsible for this failure?

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

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Fretting corrosion occurs at the contact sites between two materials under cyclic loading, such as the head-neck taper in a modular THA. Micromotion causes mechanical wear of the protective oxide layer, leading to localized electrochemical corrosion.

Question 758

Topic: Biomechanics & Biomaterials

In evaluating the biomechanical behavior of ligaments, a constant static load is applied to a ligamentous specimen over a prolonged period. It is observed that the specimen undergoes a progressive increase in deformation over time. This viscoelastic property is termed:

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

Correct Answer & Explanation

. Stress relaxation


Explanation

Creep is the viscoelastic property where a material continues to deform over time when subjected to a constant load. Stress relaxation, in contrast, is the decrease in stress over time when the material is held at a constant strain.

Question 759

Topic: Biomechanics & Biomaterials

During a cemented total knee arthroplasty, polymethylmethacrylate (PMMA) is utilized for component fixation. Which of the following statements regarding the biomechanical properties and function of PMMA is true?

. It achieves its maximum strength primarily in tension.
. The addition of barium sulfate increases its fatigue strength.
. It provides micro-interlock with cancellous bone to achieve stability.
. It acts as an adhesive, chemically bonding to the implant and bone.
. Vacuum mixing significantly increases the porosity of the cement mantle.

Correct Answer & Explanation

. It achieves its maximum strength primarily in tension.


Explanation

PMMA acts as a grout rather than a chemical adhesive, providing primary stability through mechanical interlock with cancellous bone. It is strong in compression but weak in tension, and additives like barium sulfate decrease its fatigue strength.

Question 760

Topic: Biomechanics & Biomaterials

During mechanical testing of a novel titanium alloy plate, the material is loaded in tension until catastrophic failure occurs. The total area under the stress-strain curve prior to failure represents the material's:

. Elastic modulus
. Ultimate tensile strength
. Toughness
. Ductility
. Yield strength

Correct Answer & Explanation

. Elastic modulus


Explanation

Toughness represents the total energy a material can absorb before it fractures, visually represented by the total area under the stress-strain curve. Elastic modulus corresponds to the slope of the linear elastic region.