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Question 1601

Topic: Biomechanics & Biomaterials

When a constant mechanical load is applied to a viscoelastic material such as a ligament, the material will undergo progressive deformation over time. This biomechanical phenomenon is referred to as:

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

Correct Answer & Explanation

. Creep


Explanation

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

Question 1602

Topic: Biomechanics & Biomaterials

If an orthopedic surgeon inadvertently uses a stainless steel screw through a titanium alloy locking plate, what mode of hardware failure or degradation is most likely to be accelerated?

. Crevice corrosion
. Galvanic corrosion
. Fretting corrosion
. Stress shielding
. Intergranular corrosion

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Galvanic corrosion occurs when two dissimilar metals are placed in physical contact within an electrolytic environment (such as bodily fluids). This sets up an electrochemical cell that accelerates the degradation of the more anodic metal.

Question 1603

Topic: Biomechanics & Biomaterials

On a stress-strain curve testing a specific orthopedic biomaterial, the concept of 'toughness' is best represented by which of the following?

. The total area under the stress-strain curve
. The slope of the linear elastic region
. The maximum stress before failure
. The point of transition from elastic to plastic deformation
. The area strictly under the linear elastic portion

Correct Answer & Explanation

. The total area under the stress-strain curve


Explanation

Toughness is the ability of a material to absorb energy and deform plastically before fracturing. It is represented by the total area under the stress-strain curve. The slope of the linear elastic region represents stiffness (Young's modulus). The maximum stress represents ultimate tensile strength. The transition point is the yield strength, and the area under the elastic portion is the resilience.

Question 1604

Topic: Biomechanics & Biomaterials

In total hip arthroplasty, highly cross-linked polyethylene (XLPE) inserts significantly reduce wear rates. However, increasing the radiation dose during cross-linking has which of the following detrimental effects on the material properties?

. Increases the rate of oxidation
. Decreases the ultimate tensile strength and fatigue resistance
. Increases the coefficient of friction
. Decreases its biocompatibility
. Increases the modulus of elasticity significantly

Correct Answer & Explanation

. Decreases the ultimate tensile strength and fatigue resistance


Explanation

While highly cross-linked polyethylene drastically reduces volumetric wear, the radiation cross-linking process alters its mechanical properties. Higher radiation doses decrease ultimate tensile strength, yield strength, and fatigue resistance, increasing the risk of mechanical failure.

Question 1605

Topic: Biomechanics & Biomaterials

In orthopedic implants, the combination of a stainless steel screw with a titanium plate can lead to early implant failure. What specific type of corrosion is most likely to occur in this scenario?

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

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Galvanic corrosion occurs when two dissimilar metals are placed in physical contact within an electrolytic medium, such as body fluid. The less noble metal undergoes accelerated corrosion due to the electrochemical potential difference.

Question 1606

Topic: Biomechanics & Biomaterials

Which of the following metallic orthopaedic biomaterials has a modulus of elasticity that most closely approximates that of human cortical bone, thereby reducing the effect of stress shielding?

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

Correct Answer & Explanation

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


Explanation

The modulus of elasticity of cortical bone is approximately 15-20 GPa. Titanium alloys (approx. 110 GPa) are much closer to cortical bone than stainless steel (approx. 200 GPa) or cobalt-chromium alloys (approx. 220-240 GPa). This closer match helps minimize stress shielding. Tantalum has a very low modulus closer to cancellous bone (approx. 3 GPa).

Question 1607

Topic: Biomechanics & Biomaterials

In orthopedic biomechanics, an interosseous ligament is held at a constant deformed length over an extended period. The observation that the internal tension within the ligament progressively decreases over time is defined as:

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

Correct Answer & Explanation

. Stress relaxation


Explanation

Stress relaxation is a viscoelastic property where a tissue subjected to a constant displacement (length) exhibits a decrease in stress (tension) over time. In contrast, creep refers to progressive deformation over time under a constant load.

Question 1608

Topic: Biomechanics & Biomaterials

Which of the following orthopedic implant materials exhibits a modulus of elasticity most closely approximating that of cortical bone?

. Cobalt-chromium alloy
. Stainless steel 316L
. Titanium alloy
. Polymethylmethacrylate (PMMA)
. Alumina ceramic

Correct Answer & Explanation

. Titanium alloy


Explanation

Titanium alloys have a modulus of elasticity (approx. 110 GPa) that is closer to cortical bone (approx. 15-20 GPa) than stainless steel (200 GPa) or cobalt-chromium (220 GPa). This closer match reduces the risk of stress shielding.

Question 1609

Topic: Biomechanics & Biomaterials

When mixing different metals in orthopedic implants, galvanic corrosion is a significant concern. Which of the following material combinations possesses the highest risk for severe galvanic corrosion in vivo?

. Titanium alloy and Cobalt-Chromium
. Stainless steel and Cobalt-Chromium
. Stainless steel and Titanium alloy
. Titanium alloy and Tantalum
. Ceramic and Titanium alloy

Correct Answer & Explanation

. Stainless steel and Titanium alloy


Explanation

Combining stainless steel and titanium alloy creates a strong electrochemical potential difference, leading to severe galvanic corrosion of the less noble metal (stainless steel). Titanium and cobalt-chromium can often be used together safely.

Question 1610

Topic: Biomechanics & Biomaterials

During total joint arthroplasty, antibiotic-loaded polymethylmethacrylate (PMMA) bone cement is often utilized. To be effective and not compromise the cement properties, the chosen antibiotic must primarily be:

. Thermostable and available in powder form
. Highly protein-bound and liquid
. Thermolabile and bacteriostatic
. Anaerobic specific and granular
. Hydrophobic and available in liquid form

Correct Answer & Explanation

. Thermostable and available in powder form


Explanation

Antibiotics mixed into PMMA must be thermostable to survive the highly exothermic polymerization reaction of the cement. They must also be in powder form to allow uniform mixing and elution without severely compromising the cement's mechanical strength.

Question 1611

Topic: Biomechanics & Biomaterials

According to the principles of fracture biomechanics, how does increasing the distance between the near and far cortices at a fracture gap (increasing gap size) affect interfragmentary strain, assuming interfragmentary motion remains constant?

. Increases interfragmentary strain
. Decreases interfragmentary strain
. Has no effect on interfragmentary strain
. Eliminates all strain
. Reverses the strain direction

Correct Answer & Explanation

. Decreases interfragmentary strain


Explanation

Interfragmentary strain is defined as the change in gap length divided by the original gap length. Therefore, for a given amount of motion (change in length), increasing the original gap size mathematically decreases the overall strain.

Question 1612

Topic: Biomechanics & Biomaterials

A surgeon plans to revise a fractured femur using a titanium locking plate and stainless steel screws. What is the primary biomechanical and chemical risk of combining these two metals in vivo?

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

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Galvanic corrosion occurs when two dissimilar metals are in contact within an electrolytic fluid, causing an electrochemical potential difference. Using titanium and stainless steel together increases the risk of this specific type of corrosion, potentially leading to implant failure.

Question 1613

Topic: Biomechanics & Biomaterials

Stress shielding around a non-cemented total hip arthroplasty stem is primarily related to a mismatch in which of the following physical properties between the implant and native bone?

. Ultimate tensile strength
. Yield point
. Modulus of elasticity
. Fatigue strength
. Ductility

Correct Answer & Explanation

. Modulus of elasticity


Explanation

Stress shielding occurs when a stiff implant bears the mechanical load instead of the surrounding bone, leading to adaptive osteopenia. This phenomenon is directly related to the mismatch in the modulus of elasticity (stiffness) between the metallic implant and the native bone.

Question 1614

Topic: Biomechanics & Biomaterials

Which type of corrosion is most likely to occur when a stainless steel screw is used to secure a titanium plate in fracture fixation?

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

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Galvanic corrosion occurs when two dissimilar metals are placed in an electrolytic solution like bodily fluids, causing the less noble metal to corrode. Using stainless steel and titanium implants in direct contact should be avoided to prevent this complication.

Question 1615

Topic: Biomechanics & Biomaterials

Which of the following biomechanical terms accurately describes the progressive, time-dependent elongation of a ligament when it is subjected to a constant applied load?

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

Correct Answer & Explanation

. Creep


Explanation

Creep is the viscoelastic property where a tissue gradually deforms (elongates) over time under a constant load. Conversely, stress relaxation is the progressive decrease in stress when a tissue is held at a constant length.

Question 1616

Topic: Biomechanics & Biomaterials

Which of the following material combinations in a modular total hip arthroplasty carries the highest risk of galvanic corrosion?

. Titanium alloy stem and cobalt-chromium head
. Cobalt-chromium stem and cobalt-chromium head
. Titanium alloy stem and ceramic head
. Cobalt-chromium stem and ceramic head
. Stainless steel stem and stainless steel head

Correct Answer & Explanation

. Titanium alloy stem and cobalt-chromium head


Explanation

Galvanic corrosion occurs when two dissimilar metals are in contact within an electrolytic environment, such as bodily fluids. A titanium alloy stem coupled with a cobalt-chromium head represents a classic mixed-metal couple prone to galvanic and fretting corrosion at the trunnion.

Question 1617

Topic: Biomechanics & Biomaterials
Which of the following factors most significantly increases the rate of volumetric wear of conventional ultra-high molecular weight polyethylene (UHMWPE) in total hip arthroplasty?
. Decreased femoral head size
. Increased polyethylene thickness
. Highly cross-linking the polyethylene
. Increased femoral head size
. Using a ceramic femoral head instead of cobalt-chrome

Correct Answer & Explanation

. Increased femoral head size


Explanation

Volumetric wear of conventional UHMWPE increases with larger femoral head sizes due to the increased sliding distance per step. Conversely, linear wear may increase with smaller heads due to higher focal contact pressures. Highly cross-linked polyethylene significantly reduces both volumetric and linear wear. Ceramic heads also reduce wear rates compared to cobalt-chrome.

Question 1618

Topic: Biomechanics & Biomaterials

Highly cross-linked polyethylene (HXLPE) is the standard bearing surface used in modern total hip arthroplasty due to its significantly decreased volumetric wear. However, the process of cross-linking and subsequent melting or annealing to eliminate free radicals leads to a clinically relevant decrease in which of the following mechanical properties?

. Surface hardness and scratch resistance
. Fatigue resistance and ultimate tensile strength
. Modulus of elasticity
. Oxidation resistance in vivo
. Coefficient of friction

Correct Answer & Explanation

. Fatigue resistance and ultimate tensile strength


Explanation

Irradiation of polyethylene creates cross-links that drastically reduce abrasive and adhesive volumetric wear. However, irradiation also breaks polymer chains, creating free radicals. Subsequent thermal treatments (melting or annealing) are required to eliminate these free radicals to prevent oxidation. This thermal treatment reduces the crystallinity of the polyethylene, which decreases its fatigue resistance, yield strength, ductility, and ultimate tensile strength. This is why highly cross-linked polyethylene must be used cautiously in high-stress, non-conforming joints like the knee or in very thin liners.

Question 1619

Topic: Biomechanics & Biomaterials

A 55-year-old male undergoes a total hip arthroplasty. To minimize the risk of galvanic corrosion, the surgeon must be cautious about metal combinations. Which combination of stem and head materials is most strongly associated with galvanic and fretting corrosion at the trunnion?

. Titanium alloy stem with Ceramic head
. Cobalt-chromium stem with Ceramic head
. Titanium alloy stem with Cobalt-chromium head
. Stainless steel stem with Stainless steel head
. Oxinium head with Titanium alloy stem

Correct Answer & Explanation

. Titanium alloy stem with Cobalt-chromium head


Explanation

The combination of a titanium alloy stem with a cobalt-chromium head introduces dissimilar metals at the modular junction, increasing the risk of galvanic and fretting corrosion (trunnionosis). Ceramic heads are electrically insulating and do not cause galvanic corrosion.

Question 1620

Topic: Biomechanics & Biomaterials

In the context of orthopedic biomechanics and materials science, what does the "yield point" on a stress-strain curve specifically represent?

. The maximum stress a material can withstand before catastrophic failure
. The exact transition point from elastic to plastic deformation
. The point of material fatigue after repetitive cyclic loading
. The initial linear region corresponding precisely to Hooke's Law
. The total kinetic energy absorbed by the material immediately prior to fracture

Correct Answer & Explanation

. The exact transition point from elastic to plastic deformation


Explanation

The yield point marks the end of elastic deformation (where a material returns to its original shape) and the onset of plastic deformation (resulting in permanent shape change). Beyond this specific point, Hooke's Law is no longer applicable.