This practice set contains high-yield board review questions covering key concepts in Biomechanics & Biomaterials. Each clinical scenario is designed to test your diagnostic and management skills relevant to this subspecialty.
Question 81
Topic: Biomechanics & Biomaterials
Cortical bone exhibits viscoelastic properties, meaning its biomechanical behavior changes depending on the rate of loading. During a high-speed motor vehicle collision, a femur is loaded at a very high strain rate. Compared to a low-energy fall, how does the bone behave?
Correct Answer & Explanation
. It becomes stiffer and absorbs more energy before fracturing.
Explanation
Because bone is viscoelastic, it becomes stiffer and stronger at higher strain rates, allowing it to absorb more energy before failure. When it eventually fails, the energy release results in highly comminuted fractures.
Question 82
Topic: Biomechanics & Biomaterials
An orthopaedic implant engineer is comparing the fatigue properties of different orthopaedic biomaterials. Which of the following materials has a Young's Modulus of Elasticity closest to that of human cortical bone, thereby theoretically reducing stress shielding?
Correct Answer & Explanation
. Titanium alloy (Ti-6Al-4V)
Explanation
Titanium alloy has a Young's Modulus (approx. 110 GPa) that is closer to cortical bone (15-20 GPa) than stainless steel (200 GPa) or Cobalt-Chromium (240 GPa). This closer matching reduces stress shielding but makes the implant more susceptible to notch sensitivity.
Question 83
Topic: Biomechanics & Biomaterials
During a revision total hip arthroplasty, the surgeon notices significant corrosion at the modular head-neck junction. The femoral stem is made of a titanium alloy, while the modular head is cobalt-chromium. Which type of corrosion is most directly caused by the pairing of these dissimilar metals?
Correct Answer & Explanation
. Galvanic corrosion
Explanation
Galvanic corrosion occurs when two dissimilar metals with different electrochemical potentials are placed in contact within a conductive fluid (like body fluids). It causes accelerated corrosion of the less noble metal.
Question 84
Topic: Biomechanics & Biomaterials
A mechanical test is performed on an anterior cruciate ligament (ACL) graft. The stress-strain curve initially demonstrates a non-linear 'toe region' before becoming linear. What microstructural event is responsible for this toe region?
Correct Answer & Explanation
. Uncrimping of the resting collagen fibrils
Explanation
The non-linear 'toe region' at the beginning of a ligament's stress-strain curve corresponds to the uncrimping (straightening) of the naturally wavy collagen fibrils as initial tension is applied.
Question 85
Topic: Biomechanics & Biomaterials
Nine months following open reduction and internal fixation of a diaphyseal femur fracture, a patient returns with sudden thigh pain. Radiographs reveal a broken plate and persistent nonunion. The plate failure occurred despite no single load exceeding the material's ultimate tensile strength. This failure mechanism is termed:
Correct Answer & Explanation
. Fatigue failure
Explanation
Fatigue failure occurs when a material breaks under repeated, cyclical loading at stress levels well below its ultimate tensile strength. It is commonly seen in orthopaedic implants when delayed union or nonunion subjects the hardware to prolonged cyclical stress.
Question 86
Topic: Biomechanics & Biomaterials
When preparing polymethylmethacrylate (PMMA) bone cement for fixing a pathological fracture, the surgeon must understand its mechanical limitations. PMMA is strongest under which of the following mechanical forces?
Correct Answer & Explanation
. Compression
Explanation
PMMA bone cement performs exceptionally well under compressive loads. However, it is very weak against tensile and shear forces, which is why it is used as a volume filler and grout rather than a structural adhesive.
Question 87
Topic: Biomechanics & Biomaterials
Cortical bone is described as an 'anisotropic' material. Which of the following statements best defines this property in the context of orthopaedic biomechanics?
Correct Answer & Explanation
. Its mechanical properties are directionally dependent.
Explanation
Anisotropy means a material's mechanical properties depend on the direction of loading. For example, cortical bone is much stronger in longitudinal compression than in transverse tension.
Question 88
Topic: Biomechanics & Biomaterials
A researcher is developing a novel polyethylene component for a total knee arthroplasty. They note that under a constant, unchanging compressive load over several years, the material slowly undergoes increasing plastic deformation. This specific time-dependent property is called:
Correct Answer & Explanation
. Creep
Explanation
Creep is the progressive deformation of a viscoelastic material over time when subjected to a constant load. Conversely, stress relaxation is the decrease in stress over time when the material is held at a constant deformation.
Question 89
Topic: Biomechanics & Biomaterials
To minimize stress shielding around a non-cemented femoral stem, the implant material should ideally have an elastic (Young's) modulus close to that of cortical bone. Among the following orthopedic metals, which has the lowest elastic modulus?
Correct Answer & Explanation
. Titanium alloy
Explanation
Titanium alloy has an elastic modulus (approx. 100-110 GPa) that is closer to cortical bone (15-20 GPa) than stainless steel (200 GPa) or cobalt-chromium (220 GPa). This closer match reduces the stress shielding effect.
Question 90
Topic: Biomechanics & Biomaterials
Cortical bone exhibits viscoelastic properties. When loaded at a very high strain rate, such as during a high-velocity trauma, how do the mechanical properties of the bone change compared to a low strain rate?
Correct Answer & Explanation
. It becomes stiffer and absorbs more energy before failure
Explanation
Due to its viscoelastic nature, bone is strain-rate dependent. At higher loading rates, bone becomes stiffer, withstands higher loads, and absorbs more energy before it fails catastrophically.
Question 91
Topic: Biomechanics & Biomaterials
A surgeon accidentally uses a stainless steel screw through a titanium plate during fracture fixation. This mixed-metal construct places the patient at highest risk for which type of corrosion?
Correct Answer & Explanation
. Galvanic corrosion
Explanation
Galvanic corrosion occurs when two dissimilar metals are in direct electrical contact within a conductive fluid environment (like body fluids). The less noble metal acts as an anode and corrodes faster.
Question 92
Topic: Biomechanics & Biomaterials
Which of the following statements correctly describes the inherent mechanical properties of polymethylmethacrylate (PMMA) bone cement?
Correct Answer & Explanation
. It is significantly stronger in compression than in tension
Explanation
PMMA is a brittle material that is highly effective at resisting compressive loads but is weak in tension and shear. It functions as a grout via mechanical interlock, not as an adhesive, and adding large amounts of antibiotics decreases its fatigue strength.
Question 93
Topic: Biomechanics & Biomaterials
On the stress-strain curve for an orthopedic alloy, the exact point at which the material transitions from elastic (recoverable) deformation to plastic (permanent) deformation is known as the:
Correct Answer & Explanation
. Yield point
Explanation
The yield point marks the end of the elastic region on a stress-strain curve. Loading the material beyond this point causes permanent, irreversible plastic deformation.
Question 94
Topic: Biomechanics & Biomaterials
Cortical bone exhibits different mechanical properties (e.g., strength, stiffness) depending on the direction of the applied load. This fundamental biomechanical property is termed:
Correct Answer & Explanation
. Anisotropy
Explanation
Anisotropy refers to a material having directionally dependent properties. Cortical bone is highly anisotropic, being much stronger in resisting longitudinal compression than transverse loads or shear.
Question 95
Topic: Biomechanics & Biomaterials
Compared to standard ultra-high-molecular-weight polyethylene (UHMWPE), highly cross-linked polyethylene used in THA offers which of the following mechanical trade-offs?
Correct Answer & Explanation
. Increased wear resistance and decreased fatigue crack propagation resistance
Explanation
High-dose irradiation cross-links the polyethylene, significantly reducing adhesive and abrasive wear. However, this process decreases mechanical properties such as ductility, toughness, and fatigue crack propagation resistance.
Question 96
Topic: Biomechanics & Biomaterials
In orthopedic biomechanics, what term describes the phenomenon where a viscoelastic material undergoes increasing deformation over time under a constant applied load?
Correct Answer & Explanation
. Creep
Explanation
Creep is defined as the progressive deformation of a viscoelastic material when subjected to a constant load over time. This is distinct from stress relaxation, which is the decrease in stress over time under a constant deformation.
Question 97
Topic: Biomechanics & Biomaterials
In orthopedic biomechanics, the gradual and progressive deformation of a viscoelastic material over time when subjected to a constant, sustained load is defined as what?
Correct Answer & Explanation
. Creep
Explanation
Creep is the time-dependent deformation of a material under a constant applied load or stress. This is distinct from stress relaxation, which is the decrease in stress over time when a material is held at a constant strain or length.
Question 98
Topic: Biomechanics & Biomaterials
A surgeon is choosing an intramedullary nail for a young, active patient with a tibia fracture. They are considering two options: one made of stainless steel and another of titanium alloy. From a biomechanical perspective, which material property is most relevant to minimizing long-term stress shielding of the bone?
Correct Answer & Explanation
. Young's Modulus.
Explanation
Correct Answer: DYoung's Modulus (or modulus of elasticity) is a measure of a material's stiffness or resistance to elastic deformation under stress. Cortical bone has a Young's Modulus of approximately 17-20 GPa. Stainless steel has a Young's Modulus of around 200 GPa, while titanium alloys are closer at approximately 110 GPa. The greater the mismatch in stiffness between the implant and the bone, the more the implant will bear the physiological load, leading to stress shielding of the adjacent bone. Therefore, a lower Young's Modulus (like that of titanium) is biomechanically advantageous for reducing stress shielding, allowing the bone to experience more physiological stress and promoting its natural remodeling and healing processes. Other properties like tensile strength, hardness, corrosion resistance, and fatigue limit are important for implant integrity but are not the primary drivers of stress shielding.
Question 99
Topic: Biomechanics & Biomaterials
A surgeon is fixing a pediatric forearm fracture and wants to minimize the need for future hardware removal. Which screw material would be most appropriate, considering biocompatibility and biomechanics?
Correct Answer & Explanation
. Bioabsorbable Polymer (e.g., PLLA)
Explanation
Correct Answer: DBioabsorbable polymers like Poly-L-lactic acid (PLLA) or polylactide-co-glycolide (PLGA) are specifically designed to degrade over time, eliminating the need for a second surgery for hardware removal. This is particularly advantageous in pediatric fractures where bone remodeling is significant and future growth is a concern. While stainless steel (Option A) and titanium (Option C) are highly biocompatible, they are permanent implants requiring removal if they cause symptoms or interfere with growth. Cobalt-chrome (Option B) is strong but generally used for bearing surfaces in joint replacements. Nitinol (Option E) is a shape-memory alloy used in specific applications like staples or small implants, but less commonly for primary fracture fixation screws meant to absorb.
Question 100
Topic: Biomechanics & Biomaterials
A 42-year-old patient requires internal fixation for a long bone fracture. The surgeon is debating between a 316L stainless steel plate and a Ti-6Al-4V titanium alloy plate. From a long-term biological and biomechanical perspective, what is a distinct advantage of the titanium alloy plate?
Correct Answer & Explanation
. Titanium alloys have a lower modulus of elasticity, which can help mitigate stress shielding.
Explanation
Correct Answer: CTitanium alloys (e.g., Ti-6Al-4V) have a modulus of elasticity that is closer to that of cortical bone compared to 316L stainless steel. This property makes titanium more 'bone-friendly' as it more closely matches the elastic modulus of bone. This congruence can help reduce the magnitude of stress shielding, a phenomenon where the implant bears too much load, leading to disuse osteopenia in the underlying bone. While both materials are strong, the elastic modulus difference is a key biomechanical advantage for titanium in terms of long-term bone health.Option A is incorrect:Stainless steel is generally more radio-opaque than titanium, making titanium implants sometimes harder to visualize clearly on plain radiographs.Option B is incorrect:While modern titanium alloys have excellent fatigue resistance, 316L stainless steel also has very good fatigue properties. The statement 'superior fatigue resistance' is not a universally distinct advantage of titanium over stainless steel in all forms.Option D is incorrect:This statement is true (stainless steel is more prone to corrosion and ion release), but it describes a disadvantage of stainless steel, not an advantage of titanium. The question asks for a distinct advantage of titanium.Option E is incorrect:Titanium alloys are generally more expensive and more challenging to manufacture than stainless steel, making this statement incorrect.
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