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Question 1521

Topic: Biomechanics & Biomaterials

When a stainless steel screw is placed through a titanium plate in a fracture fixation construct, which specific type of corrosion is most likely to accelerate device failure?

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

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Galvanic corrosion occurs when two dissimilar metals are in direct contact within a conductive fluid environment, such as human blood or serum. The less noble metal (stainless steel) acts as an anode and corrodes rapidly.

Question 1522

Topic: Biomechanics & Biomaterials
Which sterilization method for ultra-high-molecular-weight polyethylene (UHMWPE) components is most highly associated with long-term oxidative degradation and increased wear rates?
. Gamma irradiation in an inert gas environment
. Gamma irradiation in air
. Ethylene oxide gas sterilization
. Gas plasma sterilization
. Electron beam irradiation in a vacuum

Correct Answer & Explanation

. Gamma irradiation in air


Explanation

Gamma irradiation in air creates free radicals that react with ambient oxygen over time. This leads to oxidative chain scission, decreasing the molecular weight and significantly increasing the wear rate of the polyethylene.

Question 1523

Topic: Biomechanics & Biomaterials

To avoid galvanic corrosion in orthopedic implants, dissimilar metals should generally not be mixed. Which of the following combinations is most likely to result in significant galvanic corrosion?

. Titanium alloy and Cobalt-Chromium alloy
. 316L Stainless Steel and Titanium alloy
. Tantalum and Titanium alloy
. Cobalt-Chromium alloy and Zirconium
. Ceramic (Alumina) and Titanium alloy

Correct Answer & Explanation

. 316L Stainless Steel and Titanium alloy


Explanation

Stainless steel is significantly less noble than titanium on the galvanic series. When placed in contact within a conductive fluid (body tissue), stainless steel acts as the anode and corrodes rapidly, making this combination strictly contraindicated.

Question 1524

Topic: Biomechanics & Biomaterials

A surgeon uses a stainless steel cerclage wire in combination with a titanium plate for a femoral fracture fixation. Months later, localized bone resorption and implant failure are noted at the junction of the two metals. Which type of corrosion is most likely responsible for this failure?

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

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Galvanic corrosion occurs when two dissimilar metals with different anodic indices are placed in electrical contact within an electrolytic environment, such as the human body. The less noble metal acts as an anode and undergoes accelerated corrosion. Using implants of the same material prevents this complication.

Question 1525

Topic: Biomechanics & Biomaterials
In total joint arthroplasty, ultra-high-molecular-weight polyethylene (UHMWPE) is often highly cross-linked to improve performance. What is the most significant mechanical trade-off associated with high cross-linking?
. Decreased wear resistance
. Increased oxidative degradation
. Decreased fracture toughness and ductility
. Increased risk of third-body wear
. Decreased elastic modulus

Correct Answer & Explanation

. Decreased fracture toughness and ductility


Explanation

Highly cross-linking UHMWPE significantly improves its resistance to adhesive and abrasive wear. However, this process alters the polymer chains, leading to a reduction in mechanical properties such as fracture toughness, ductility, and fatigue strength.

Question 1526

Topic: Biomechanics & Biomaterials

Which of the following orthopedic implant materials has an elastic (Young's) modulus most closely resembling that of human cortical bone?

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

Correct Answer & Explanation

. Titanium alloy


Explanation

Titanium alloy has an elastic modulus of roughly 110 GPa, which is closer to human cortical bone (15-20 GPa) than stainless steel (200 GPa) or cobalt-chromium (220 GPa). This closer match reduces stress shielding around the implant.

Question 1527

Topic: Biomechanics & Biomaterials

On a stress-strain curve of a metallic orthopedic implant, what point represents the maximum stress a material can withstand before permanent deformation occurs?

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

Correct Answer & Explanation

. Yield point


Explanation

The yield point marks the end of the elastic region and the beginning of plastic (permanent) deformation. The modulus of elasticity is simply the slope of the elastic region.

Question 1528

Topic: Biomechanics & Biomaterials

A 45-year-old male undergoes revision internal fixation for a femoral shaft nonunion. The surgeon plans to use a stainless steel plate with the retained titanium screws from the index procedure. Which of the following best describes the primary type of corrosion that is likely to occur?

. Crevice corrosion
. Fretting corrosion
. Galvanic corrosion
. Pitting corrosion
. Uniform corrosion

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Galvanic corrosion occurs when two dissimilar metals (e.g., titanium and stainless steel) are placed in contact within a conductive fluid environment (body fluid). The less noble metal undergoes accelerated corrosion due to electrochemical differences.

Question 1529

Topic: Biomechanics & Biomaterials

Which of the following factors is most strongly associated with increased volumetric wear of highly cross-linked polyethylene in total hip arthroplasty?

. Decreased femoral head size
. Increased femoral head size
. Increased polyethylene thickness
. Use of a ceramic femoral head
. Sterilization in an inert gas environment

Correct Answer & Explanation

. Increased femoral head size


Explanation

Increased femoral head size increases the sliding distance per step, which inherently increases volumetric wear of the polyethylene liner, although it decreases the risk of dislocation. While highly cross-linked polyethylene mitigates wear compared to conventional polyethylene, the physical relationship with head size remains.

Question 1530

Topic: Biomechanics & Biomaterials

During the application of a halo vest, the pins are initially torqued to 8 in-lbs. After 48 hours, the torque on the pins is measured and found to have decreased, despite the pins not visibly moving. Which of the following viscoelastic properties best explains this phenomenon?

. Creep
. Stress relaxation
. Hysteresis
. Fatigue failure
. Isotropy

Correct Answer & Explanation

. Stress relaxation


Explanation

Stress relaxation is a viscoelastic property defined as a decrease in stress (or torque) over time when a material is held at a constant strain (or deformation). Creep, conversely, is the progressive deformation (strain) of a material over time under a constant load.

Question 1531

Topic: Biomechanics & Biomaterials

Which of the following orthopedic implant materials possesses a modulus of elasticity that most closely matches that of normal human cortical bone, thereby minimizing stress shielding?

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

Correct Answer & Explanation

. Titanium alloy (Ti-6Al-4V)


Explanation

The modulus of elasticity (stiffness) of cortical bone is roughly 15-20 GPa. Titanium alloys (approx. 110 GPa) are closer to this value than 316L stainless steel (~200 GPa) or Cobalt-chromium (~220 GPa). This relative flexibility helps reduce stress shielding of the adjacent bone compared to stiffer metals. PMMA has a much lower modulus (~3 GPa).

Question 1532

Topic: Biomechanics & Biomaterials

When a stainless steel plate is fixed with titanium screws in an orthopedic construct, accelerated localized corrosion may occur at the screw-plate interface over time. Which specific type of corrosion is primarily responsible for this degradation?

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

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Galvanic corrosion occurs when two electrochemically dissimilar metals (e.g., stainless steel and titanium) are placed in direct physical contact within a conductive fluid environment (body fluids). An electrochemical cell is created where the less noble metal acts as the anode and undergoes accelerated corrosion.

Question 1533

Topic: Biomechanics & Biomaterials

A 45-year-old male undergoes revision ORIF for a nonunion of the femur. The surgeon uses a stainless steel plate and titanium screws. Which of the following best describes the likely consequence of mixing these metals in vivo?

. Crevice corrosion
. Galvanic corrosion
. Fretting corrosion
. Pitting corrosion
. No adverse effect

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Mixing dissimilar metals with different anodic/cathodic potentials in an electrolytic environment (body fluid) leads to galvanic corrosion. Stainless steel and titanium have different potentials, making the stainless steel more susceptible to anodic dissolution when coupled with titanium.

Question 1534

Topic: Biomechanics & Biomaterials
What is the primary purpose of highly cross-linking ultra-high molecular weight polyethylene (UHMWPE) used in total joint arthroplasty?
. To increase the ultimate tensile strength
. To improve resistance to adhesive and abrasive wear
. To increase the ductility of the material
. To reduce the risk of implant fracture
. To enhance the oxidation resistance without additives

Correct Answer & Explanation

. To improve resistance to adhesive and abrasive wear


Explanation

Cross-linking UHMWPE using gamma irradiation significantly improves its resistance to adhesive and abrasive wear, thereby minimizing wear debris and reducing the incidence of periprosthetic osteolysis. However, this process sacrifices mechanical properties, decreasing ultimate tensile strength, fatigue strength, and ductility.

Question 1535

Topic: Biomechanics & Biomaterials

A new titanium alloy is undergoing biomechanical testing for intramedullary nail fabrication. The material deforms under an applied load and returns precisely to its original shape once the load is removed. The maximum stress this material can withstand before permanently deforming is known as which of the following?

. Ultimate tensile strength
. Yield point
. Fatigue limit
. Young's modulus
. Failure point

Correct Answer & Explanation

. Yield point


Explanation

The yield point marks the end of the elastic region on a stress-strain curve. Stress applied beyond this point will result in plastic, irreversible deformation of the material.

Question 1536

Topic: Biomechanics & Biomaterials
In the manufacturing of highly cross-linked ultra-high-molecular-weight polyethylene (UHMWPE) for total joint arthroplasty, gamma irradiation is used to promote cross-linking. Which subsequent processing step is critical to prevent long-term oxidative degradation of the implant?
. Cold sterilization with ethylene oxide
. Calcium phosphate coating
. Melting or annealing
. Plasma spraying
. Quenching in liquid nitrogen

Correct Answer & Explanation

. Melting or annealing


Explanation

Gamma irradiation generates free radicals that leave the polyethylene susceptible to oxidation in vivo. Remelting or annealing the plastic eliminates these free radicals, significantly improving long-term wear resistance.

Question 1537

Topic: Biomechanics & Biomaterials

During the correction of a severe knee flexion contracture, a physical therapist applies a static, constant force splint. Over several weeks, the soft tissues progressively lengthen despite the force remaining unchanged. This viscoelastic property is termed:

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

Correct Answer & Explanation

. Creep


Explanation

Creep describes the time-dependent, progressive deformation of a viscoelastic material when subjected to a constant applied load. Stress relaxation, conversely, is the decrease in stress over time under a constant strain.

Question 1538

Topic: Biomechanics & Biomaterials

When analyzing the stress-strain curve of a normal articular cartilage specimen loaded in tension, an initial non-linear 'toe region' is observed before the curve becomes linear. What microscopic structural change corresponds to this toe region?

. Microfailure of collagen fibrils
. Uncrimping of the collagen fibers
. Proteoglycan expansion and water influx
. Fluid exudation out of the extracellular matrix
. Complete macroscopic rupture of the tissue

Correct Answer & Explanation

. Uncrimping of the collagen fibers


Explanation

The 'toe region' represents the low-strain phase where the naturally wavy or crimped collagen fibers begin to straighten out (uncrimp) without structurally failing. Once straight, the tissue enters the linear elastic region.

Question 1539

Topic: Biomechanics & Biomaterials

In the stress-strain curve of orthopedic biomaterials, the slope of the linear elastic region represents which of the following properties?

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

Correct Answer & Explanation

. Young's modulus


Explanation

The slope of the linear elastic portion of the stress-strain curve defines Young's modulus, indicating the material's stiffness. Toughness is the area under the curve, and yield strength marks the end of elastic deformation.

Question 1540

Topic: Biomechanics & Biomaterials

Polymethylmethacrylate (PMMA) bone cement is frequently used in joint arthroplasty. The addition of barium sulfate to PMMA serves which of the following purposes?

. Increases the porosity of the cement
. Reduces the exothermic reaction temperature
. Provides radiopacity
. Accelerates the polymerization time
. Increases the ultimate tensile strength

Correct Answer & Explanation

. Provides radiopacity


Explanation

Barium sulfate or zirconium dioxide is added to PMMA to make the cement radiopaque, allowing for postoperative radiographic evaluation of the cement mantle. These additives act as stress risers and actually decrease the ultimate tensile strength of the cement.