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Question 801

Topic: Biomechanics & Biomaterials

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

. Use of a titanium alloy plate with titanium alloy screws
. Use of a stainless steel plate with titanium alloy screws
. Cyclic loading of a pure titanium implant
. Implantation of an ultra-high molecular weight polyethylene component
. Use of a cobalt-chromium femoral head with a highly cross-linked polyethylene liner

Correct Answer & Explanation

. Use of a titanium alloy plate with titanium alloy screws


Explanation

Galvanic corrosion occurs when two dissimilar metals (such as stainless steel and titanium) are in contact within a conductive fluid. This creates an electrochemical gradient leading to the corrosion of the less noble metal.

Question 802

Topic: Biomechanics & Biomaterials

Which of the following orthopedic implant materials has a modulus of elasticity most similar to that of human cortical bone?

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

Correct Answer & Explanation

. Cobalt-chromium alloy


Explanation

Titanium alloys have a modulus of elasticity (approx. 100-110 GPa) that is much closer to cortical bone (approx. 15-20 GPa) than stainless steel (approx. 200 GPa) or cobalt-chromium (approx. 240 GPa). This closer match helps minimize stress shielding.

Question 803

Topic: Biomechanics & Biomaterials

During the surgical correction of a relapsed clubfoot, a surgeon applies a sequential series of corrective casts. The gradual stretching of the contracted soft tissues over time under a constant applied load is an example of which viscoelastic property?

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

Correct Answer & Explanation

. Creep


Explanation

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

Question 804

Topic: Biomechanics & Biomaterials

In the stress-strain curve of a cortical bone specimen under tension, which of the following mechanical properties is determined by the total area under the curve up to the point of failure?

. Elasticity
. Yield strength
. Ultimate strength
. Toughness
. Ductility

Correct Answer & Explanation

. Elasticity


Explanation

Toughness is the ability of a material to absorb energy and deform before fracturing, represented by the total area under the stress-strain curve. Ductility refers only to the amount of plastic deformation before failure.

Question 805

Topic: Biomechanics & Biomaterials

On a stress-strain curve, the total area under the curve up to the point of material failure represents which of the following mechanical properties?

. Toughness
. Stiffness
. Ductility
. Yield strength
. Viscoelasticity

Correct Answer & Explanation

. Toughness


Explanation

Toughness is the ability of a material to absorb energy and plastically deform before fracturing, represented by the total area under the stress-strain curve. Stiffness is represented by the slope of the elastic region (Young's modulus).

Question 806

Topic: Biomechanics & Biomaterials

Which type of wear in total joint arthroplasty is characterized by the transfer of material from one surface to another due to localized micro-welding and subsequent tearing?

. Abrasive wear
. Adhesive wear
. Third-body wear
. Fretting wear
. Fatigue wear

Correct Answer & Explanation

. Abrasive wear


Explanation

Adhesive wear occurs when two surfaces slide against each other, creating localized micro-welds that break and tear material away. Abrasive wear occurs when a harder surface or particle plows into a softer surface.

Question 807

Topic: Biomechanics & Biomaterials

Fretting corrosion in orthopedic implants is most commonly observed at which of the following interfaces?

. Between a titanium stem and a cobalt-chrome head
. Between a bone screw head and a bone plate hole
. Between an un-cemented stem and surrounding cortical bone
. Between a polyethylene liner and a metal acetabular shell
. Between a ceramic head and a polyethylene liner

Correct Answer & Explanation

. Between a titanium stem and a cobalt-chrome head


Explanation

Fretting corrosion occurs due to repetitive micromotion between two closely apposed metal surfaces, mechanically removing the passive oxide layer. It is classically seen at the screw-plate interface.

Question 808

Topic: Biomechanics & Biomaterials

In the context of tissue biomechanics, the viscoelastic property of load relaxation is defined as:

. Increasing deformation over time under a constant load
. Decreasing stress over time under a constant deformation
. Energy loss dissipated as heat during cyclic loading
. Increased stiffness proportional to faster loading rates
. Permanent deformation remaining after load removal

Correct Answer & Explanation

. Increasing deformation over time under a constant load


Explanation

Load (or stress) relaxation is the phenomenon where the stress within a material decreases over time while it is held at a constant strain. Creep, conversely, is increasing deformation under a constant load.

Question 809

Topic: Biomechanics & Biomaterials

On a stress-strain curve for a ligament, the initial 'toe region' represents which of the following physiological events?

. Microscopic failure of collagen fibers
. Macroscopic failure of the ligament
. Uncrimping of collagen fibers
. Plastic deformation
. Viscoelastic creep

Correct Answer & Explanation

. Microscopic failure of collagen fibers


Explanation

The toe region of the stress-strain curve represents the initial unfolding or 'uncrimping' of the wavy collagen fibers under low strain. Once uncrimped, the ligament enters the linear elastic region where stress becomes proportional to strain.

Question 810

Topic: Biomechanics & Biomaterials

Which of the following orthopedic implant materials has a modulus of elasticity most closely resembling that of normal 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 (roughly 110 GPa) closer to that of cortical bone (15-20 GPa) compared to stainless steel (200 GPa) and cobalt-chromium (220 GPa). This closer match helps minimize stress shielding.

Question 811

Topic: Biomechanics & Biomaterials

A patient undergoing gradual clubfoot correction with serial casting relies on a specific viscoelastic property of soft tissues. The progressive elongation of these contracted tissues under a constant load over time is best described as:

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

Correct Answer & Explanation

. Stress relaxation


Explanation

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

Question 812

Topic: Biomechanics & Biomaterials

In the context of viscoelastic materials, what term describes the progressive deformation of a material over time when subjected to a constant load?

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

Correct Answer & Explanation

. Stress relaxation


Explanation

Creep refers to the time-dependent progressive deformation of a material under a constant load. Stress relaxation describes a decrease in stress over time when the material is held at a constant deformation.

Question 813

Topic: Biomechanics & Biomaterials

When comparing titanium alloys to stainless steel for use in orthopedic implants, titanium primarily exhibits:

. Higher modulus of elasticity
. Greater stress shielding
. Lower modulus of elasticity
. Increased risk of galvanic corrosion when paired with identical metals
. Reduced biocompatibility

Correct Answer & Explanation

. Higher modulus of elasticity


Explanation

Titanium has a lower modulus of elasticity compared to stainless steel, making it biomechanically closer to cortical bone. This reduces the effect of stress shielding compared to stiffer metals.

Question 814

Topic: Biomechanics & Biomaterials

The "toe region" of the load-elongation curve in normal ligament biomechanics primarily represents:

. Rupture of individual collagen fascicles
. Plastic deformation of the ligament
. Uncrimping of the collagen fibrils
. Yield point of the material
. Linear elastic stretching of the collagen fibers

Correct Answer & Explanation

. Rupture of individual collagen fascicles


Explanation

The toe region reflects the initial uncrimping and straightening of the naturally wavy collagen fibers under low loads. Once straightened, the ligament enters the linear elastic region.

Question 815

Topic: Biomechanics & Biomaterials

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

. A titanium screw used with a titanium plate
. A stainless steel screw used with a titanium plate
. Use of highly cross-linked polyethylene
. A ceramic head articulating with a polyethylene liner
. Fretting motion at a modular junction of identical metals

Correct Answer & Explanation

. A titanium screw used with a titanium plate


Explanation

Galvanic corrosion is an electrochemical process that occurs when two dissimilar metals, such as stainless steel and titanium, are in physical contact within an electrolytic environment (body fluids).

Question 816

Topic: Biomechanics & Biomaterials

A clinician applies a constant deformation by placing a limb in a corrective cast. Over time, the internal tension within the constrained ligamentous structures gradually decreases. This viscoelastic property of ligaments is best defined as:

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

Correct Answer & Explanation

. Creep


Explanation

Stress relaxation is the decrease in stress (tension) over time when a viscoelastic material is held at a constant length or strain. Creep, in contrast, is the increase in length over time under a constant load.

Question 817

Topic: Biomechanics & Biomaterials

When biomechanically testing a biological ligament, a cyclic loading and unloading curve demonstrates that the unloading path does not trace the same path as the loading curve. The area between these two curves represents energy lost as heat. This property is defined as:

. Stress relaxation
. Creep
. Isotropic loading
. Hysteresis
. Anisotropy

Correct Answer & Explanation

. Stress relaxation


Explanation

Hysteresis describes the phenomenon where energy is lost (typically as heat) during the cyclic loading and unloading of a viscoelastic material. It explains why a ligament does not snap back exactly along the same load-deformation curve during unloading.

Question 818

Topic: Biomechanics & Biomaterials

Following a multi-level lumbar spinal fusion, adjacent segment disease (ASD) is a recognized complication. Which of the following surgical factors has been shown to most significantly increase the risk of developing symptomatic ASD at the proximal adjacent level?

. Use of pedicle screw fixation rather than anterior plating
. Sagittal malalignment with hypolordosis
. Use of an interbody cage
. Use of iliac crest bone graft instead of local bone
. Stand-alone anterior fusion without posterior instrumentation

Correct Answer & Explanation

. Use of pedicle screw fixation rather than anterior plating


Explanation

Postoperative sagittal malalignment, specifically hypolordosis (flatback), significantly alters the biomechanics of the unfused adjacent segments. This abnormal stress is a primary driver for the accelerated development of adjacent segment disease.

Question 819

Topic: Biomechanics & Biomaterials

A 28-year-old male powerlifter feels a tearing sensation in his anterior chest wall while performing a heavy bench press. Examination reveals an asymmetric loss of the anterior axillary fold and marked weakness in internal rotation. MRI confirms a complete rupture of the pectoralis major tendon at its humeral insertion. Based on the biomechanics of the bench press exercise, which specific fibers of the pectoralis major are typically under the greatest tension and tear first?

. Clavicular head fibers
. Superior fibers of the sternal head
. Inferior fibers of the sternal head
. Costal fibers
. Abdominal fibers

Correct Answer & Explanation

. Clavicular head fibers


Explanation

The pectoralis major tendon twists 180 degrees before inserting on the proximal humerus, meaning the inferior fibers of the sternal head insert most superiorly and proximally. During a bench press (arm extended, abducted, and externally rotated), these inferior sternal fibers are placed under maximal stretch and have a mechanical disadvantage, making them the most common starting point for a pectoralis major tendon rupture.

Question 820

Topic: Biomechanics & Biomaterials

Regarding the biomechanics of cortical bone, which statement is most accurate?

. Cortical bone is stronger in tension than compression.
. The Young's modulus of cortical bone is anisotropic.
. Creep deformation is primarily due to collagen fiber slippage under rapid loading.
. Fatigue fractures occur when bone is stressed above its ultimate strength.
. Cortical bone exhibits perfect elasticity up to its yield point.

Correct Answer & Explanation

. Cortical bone is stronger in tension than compression.


Explanation

Cortical bone is an anisotropic material, meaning its mechanical properties (like Young's modulus) vary with the direction of applied load. It is significantly stronger in compression than in tension. Creep is time-dependent deformation under constant load, not primarily due to rapid loading. Fatigue fractures result from repetitive loading below the ultimate strength. Bone exhibits viscoelastic properties, not perfect elasticity, even below the yield point.