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Question 1261

Topic: Biomechanics & Biomaterials

When a constant force is applied to a ligament over time, the ligament will gradually undergo continuous elongation. This viscoelastic property is known as:

. Stress relaxation
. Creep
. Hysteresis
. Isotropic strain
. Anisotropy

Correct Answer & Explanation

. Stress relaxation


Explanation

Creep is the time-dependent elongation of a viscoelastic material when it is subjected to a constant load or stress. In contrast, stress relaxation is the decrease in stress over time when held at a constant strain.

Question 1262

Topic: Biomechanics & Biomaterials

The non-Newtonian, shear-thinning behavior of normal synovial fluid, where viscosity decreases as the shear rate increases, is primarily conferred by which of the following molecules?

. Type II collagen
. Lubricin
. Hyaluronic acid
. Aggrecan
. Chondroitin sulfate

Correct Answer & Explanation

. Type II collagen


Explanation

Hyaluronic acid is a high-molecular-weight glycosaminoglycan that gives synovial fluid its characteristic non-Newtonian, viscoelastic properties. This allows the fluid's viscosity to decrease rapidly during fast joint movement.

Question 1263

Topic: Biomechanics & Biomaterials

Which of the following physical characteristics must an antibiotic possess to be effectively mixed into and eluted from polymethylmethacrylate (PMMA) bone cement?

. Heat lability
. High molecular weight
. Hydrophobic nature
. Heat stability
. Narrow spectrum

Correct Answer & Explanation

. Heat lability


Explanation

Antibiotics mixed into PMMA must be inherently heat stable to withstand the high exothermic temperatures generated during the cement's polymerization reaction. Common appropriate choices include vancomycin and tobramycin.

Question 1264

Topic: Biomechanics & Biomaterials

An orthopedic researcher evaluates the mechanical properties of a new implant material. The total area under the stress-strain curve up to the point of fracture is measured and found to be greatest for this new material compared to standard titanium. Which mechanical property does this specific area represent?

. Resilience
. Toughness
. Stiffness
. Ductility
. Yield strength

Correct Answer & Explanation

. Resilience


Explanation

Toughness is defined as the total area under the stress-strain curve up to the failure point, representing the total amount of energy a material can absorb before it fractures. Resilience is the area under the elastic portion only (up to the yield point). Stiffness (Young's modulus) is the slope of the elastic region. Ductility refers to the amount of plastic deformation a material undergoes before failure.

Question 1265

Topic: Biomechanics & Biomaterials

A 65-year-old man undergoes revision total hip arthroplasty for a painful, aseptic joint. Intraoperatively, significant black debris is noted around the modular head-neck junction of his cobalt-chrome head on a titanium stem. Which of the following mechanisms best explains the generation of this debris?

. Galvanic corrosion
. Pitting corrosion
. Fretting and crevice corrosion
. Intergranular corrosion
. Stress corrosion cracking

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Trunnionosis at the modular head-neck junction is primarily driven by mechanically assisted crevice corrosion (MACC). This is a combination of fretting (micromotion that continuously breaks the protective titanium dioxide passivation layer) and crevice corrosion (which occurs in the localized, acidic fluid-filled gap where oxygen is depleted). Galvanic corrosion is less dominant than historically believed because the oxide layer typically insulates the dissimilar metals.

Question 1266

Topic: Biomechanics & Biomaterials

In total joint arthroplasty, highly cross-linked polyethylene (HXLPE) is irradiated to reduce wear rates. What is the primary biological or mechanical purpose of adding Vitamin E (alpha-tocopherol) to HXLPE during manufacturing?

. To increase the degree of cross-linking
. To quench free radicals and prevent oxidation
. To lower the melting temperature for easier remelting
. To increase the crystallinity of the polymer
. To enhance the osteointegration of the acetabular liner

Correct Answer & Explanation

. To increase the degree of cross-linking


Explanation

Gamma irradiation of polyethylene creates desired cross-links but also leaves behind unreacted free radicals. If left unquenched, these free radicals react with oxygen in vivo, leading to oxidative chain scission and embrittlement. Vitamin E is a powerful antioxidant added to quench these free radicals, preventing oxidation while avoiding the mechanical strength reduction associated with thermal remelting.

Question 1267

Topic: Biomechanics & Biomaterials

A ligament is subjected to a constant physiological load. Over a period of 20 minutes, the ligament experiences a progressive, time-dependent increase in strain (elongation) despite the load remaining entirely unchanged. Which viscoelastic property does this phenomenon represent?

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

Correct Answer & Explanation

. Hysteresis


Explanation

Creep is the progressive, time-dependent deformation (increasing strain) of a viscoelastic material when subjected to a constant load (stress). Stress relaxation is the inverse: the decrease in internal stress over time when a material is held at a constant strain (constant length). Hysteresis refers to the energy lost (usually as heat) between the loading and unloading phases of a material.

Question 1268

Topic: Biomechanics & Biomaterials

An orthopedic surgeon decides to use a titanium alloy (Ti-6Al-4V) femoral stem instead of a cobalt-chromium (Co-Cr) stem for a cementless total hip arthroplasty. Which of the following mechanical properties most accurately explains the reduced risk of proximal femoral stress shielding associated with titanium?

. Higher ultimate tensile strength
. Higher yield point
. Lower modulus of elasticity
. Greater stiffness
. Higher fatigue strength

Correct Answer & Explanation

. Higher ultimate tensile strength


Explanation

Titanium alloy has a lower modulus of elasticity than cobalt-chromium, meaning it is more flexible and its properties are closer to the modulus of cortical bone. This reduces stress shielding by allowing better load transfer to the proximal femur, thereby minimizing adaptive bone resorption.

Question 1269

Topic: Biomechanics & Biomaterials

A patient with a modular cementless total hip arthroplasty presents with unexplained hip pain and rising serum cobalt levels. Radiographs show no loosening. What is the predominant mechanism of wear occurring at the head-neck taper junction (trunnionosis)?

. Adhesive wear
. Abrasive wear
. Fretting corrosion
. Galvanic corrosion
. Third-body wear

Correct Answer & Explanation

. Adhesive wear


Explanation

Trunnionosis is primarily driven by fretting corrosion, a mechanically assisted crevice corrosion occurring at the modular head-neck junction. Micromotion disrupts the protective passivation layer of the metal, leading to localized corrosive destruction and the release of metal ions.

Question 1270

Topic: Biomechanics & Biomaterials

Viscoelastic materials exhibit time-dependent mechanical properties. When a ligament is stretched to a constant length and held there over time, the tension within the ligament gradually decreases. What is this biomechanical phenomenon called?

. Creep
. Fatigue
. Isotropy
. Stress relaxation
. Hysteresis

Correct Answer & Explanation

. Creep


Explanation

Stress relaxation occurs when a viscoelastic material is subjected to a constant strain (length), resulting in a gradual decrease in stress (tension) over time. In contrast, creep is the progressive deformation of a material under a constant load.

Question 1271

Topic: Biomechanics & Biomaterials

An orthopedic surgeon decides to use a 316L stainless steel screw to fixate a titanium alloy plate for a complex fracture. Which specific type of implant degradation is most likely to occur due to this combination?

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

Correct Answer & Explanation

. Fretting corrosion


Explanation

Galvanic corrosion occurs when two dissimilar metals with different electrochemical potentials are placed in contact within a conductive fluid (such as body fluids). The less noble metal undergoes accelerated anodic dissolution.

Question 1272

Topic: Biomechanics & Biomaterials

Cortical bone exhibits different mechanical properties depending on the direction of the applied load; for example, it is significantly stronger when loaded longitudinally in compression than when loaded transversely. What is this biomechanical property called?

. Anisotropy
. Isotropy
. Viscoelasticity
. Plasticity
. Creep

Correct Answer & Explanation

. Anisotropy


Explanation

Anisotropy refers to a material exhibiting different mechanical properties in different directions of loading. Cortical bone is highly anisotropic, being strongest and stiffest along its longitudinal axis.

Question 1273

Topic: Biomechanics & Biomaterials

When evaluating the mechanical behavior of a metallic orthopedic implant, the stiffness of the material is represented by the slope of the elastic region on a stress-strain curve. Which specific mechanical term describes this slope?

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

Correct Answer & Explanation

. Yield strength


Explanation

Young's modulus (modulus of elasticity) defines a material's intrinsic stiffness and is derived from the slope of the linear, elastic portion of the stress-strain curve. A steeper slope indicates a stiffer material.

Question 1274

Topic: Biomechanics & Biomaterials

Surgeons often mix antibiotics into polymethylmethacrylate (PMMA) bone cement for local prophylaxis or treatment of periprosthetic joint infections. Which pharmacokinetic or physical characteristic is absolutely mandatory for an antibiotic to be effective in PMMA?

. Heat stability
. Bacteriostatic mechanism
. Liquid formulation
. Hydrophilic nature
. Short half-life

Correct Answer & Explanation

. Heat stability


Explanation

The polymerization of PMMA is a highly exothermic reaction that can reach temperatures above 80 degrees Celsius in vivo. Therefore, any antibiotic incorporated into the cement must be thermostable (e.g., vancomycin, tobramycin, gentamicin).

Question 1275

Topic: Biomechanics & Biomaterials

Various synthetic bone graft substitutes are utilized in orthopedic surgery to fill bone defects, acting purely as osteoconductive scaffolds. Among the following options, which material exhibits the most rapid rate of in vivo resorption?

. Calcium sulfate
. Beta-tricalcium phosphate
. Coralline hydroxyapatite
. Demineralized bone matrix
. Bioactive glass

Correct Answer & Explanation

. Calcium sulfate


Explanation

Calcium sulfate resorbs very rapidly (typically within 4 to 12 weeks), often faster than host bone can replace it. In contrast, beta-tricalcium phosphate takes several months, and hydroxyapatite can take years or may never fully resorb.

Question 1276

Topic: Biomechanics & Biomaterials

A researcher applies a constant load to a human anterior cruciate ligament graft during biomechanical testing. Over several hours, the length of the graft progressively increases without any increase in the applied force. What viscoelastic property does this phenomenon represent?

. Creep
. Stress relaxation
. Hysteresis
. Fatigue failure
. Toughness

Correct Answer & Explanation

. Creep


Explanation

Creep is the progressive deformation of a viscoelastic material over time under a constant load. In contrast, stress relaxation occurs when a material is held at a constant deformation and the required load decreases over time.

Question 1277

Topic: Biomechanics & Biomaterials

A surgeon contemplates using a stainless steel screw to secure a titanium plate during fracture fixation. This combination is generally avoided due to the risk of galvanic corrosion. In this electrochemical process, which of the following accurately describes the interaction?

. Stainless steel acts as the cathode and is protected
. Stainless steel acts as the anode and corrodes
. Titanium acts as the anode and corrodes
. Both metals corrode equally due to fretting
. The passivation layer of titanium rapidly expands

Correct Answer & Explanation

. Stainless steel acts as the cathode and is protected


Explanation

When two different metals are in contact in an electrolytic solution, galvanic corrosion occurs. The less noble metal (stainless steel) acts as the anode and undergoes accelerated corrosion, while the more noble metal (titanium) acts as the cathode.

Question 1278

Topic: Biomechanics & Biomaterials

Retrieval analysis of a failed total hip arthroplasty shows microscopic scratches, plowing, and gouges on the cobalt-chromium femoral head caused by third-body bone cement particles. What specific type of wear does this represent?

. Adhesive wear
. Abrasive wear
. Fretting wear
. Fatigue wear
. Corrosive wear

Correct Answer & Explanation

. Adhesive wear


Explanation

Abrasive wear occurs when a harder material (such as bone cement or metal particles) scratches or plows into a softer surface. Adhesive wear occurs when two bearing surfaces temporarily bond and then tear away fragments.

Question 1279

Topic: Biomechanics & Biomaterials
Historically, sterilization of ultra-high-molecular-weight polyethylene (UHMWPE) components using gamma irradiation in an oxygen-rich environment caused significant clinical failures. Which of the following best describes the mechanical alteration that occurs over time under these conditions?
. Increased ultimate tensile strength
. Decreased generation of free radicals
. Chain scission leading to decreased fatigue and wear resistance
. Increased elongation at the break point
. Enhanced resistance to adhesive wear

Correct Answer & Explanation

. Chain scission leading to decreased fatigue and wear resistance


Explanation

Gamma irradiation in the presence of oxygen leads to the formation of free radicals that react with oxygen, causing oxidative chain scission. This severely degrades the polyethylene, decreasing its fatigue strength and wear resistance.

Question 1280

Topic: Biomechanics & Biomaterials

When preparing antibiotic-loaded polymethylmethacrylate (PMMA) bone cement for a prosthetic joint infection spacer, which characteristic of the selected antibiotic is most crucial for successful incorporation, survival, and elution?

. High molecular weight
. Heat lability
. Hydrophobic nature
. Liquid formulation
. Thermal stability

Correct Answer & Explanation

. High molecular weight


Explanation

The polymerization of PMMA is a highly exothermic reaction that can easily reach temperatures above 80-100 degrees Celsius. Therefore, any incorporated antibiotic must be thermally stable (e.g., vancomycin, tobramycin) to remain bactericidal.