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Question 1641

Topic: Biomechanics & Biomaterials

A surgeon places a titanium screw through a stainless steel plate during fracture fixation. Which of the following modes of corrosion is most likely to occur at the interface of these two implants?

. Fretting corrosion
. Crevice corrosion
. Galvanic corrosion
. Pitting corrosion
. Fatigue corrosion

Correct Answer & Explanation

. Galvanic corrosion


Explanation

Galvanic corrosion occurs when two dissimilar metals are placed in physical contact within a conductive fluid like body serum. The less noble metal undergoes accelerated corrosion due to an electrochemical electron transfer.

Question 1642

Topic: Biomechanics & Biomaterials

A resident is tensioning a hamstring autograft for an ACL reconstruction. They apply a constant load to the graft for 5 minutes and observe that the graft gradually lengthens. Which viscoelastic property does this describe?

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

Correct Answer & Explanation

. Creep


Explanation

Creep is the progressive deformation (lengthening) of a viscoelastic material over time when subjected to a constant load. Stress relaxation, conversely, is the decrease in internal stress over time under a constant strain.

Question 1643

Topic: Biomechanics & Biomaterials

Which characteristic is essential for an antibiotic to be effective and safe when mixed into polymethylmethacrylate (PMMA) bone cement for a joint spacer?

. High thermal lability
. Bacteriostatic rather than bactericidal mechanism
. Low water solubility to prevent rapid elution
. Availability in a liquid formulation
. Broad-spectrum coverage with high thermal stability

Correct Answer & Explanation

. Broad-spectrum coverage with high thermal stability


Explanation

Antibiotics used in PMMA must have high thermal stability to withstand the highly exothermic polymerization reaction of the cement. They must also be available as a powder and be water-soluble to allow for proper elution into the joint space.

Question 1644

Topic: Biomechanics & Biomaterials

A viscoelastic material subjected to a constant deformation will demonstrate a gradual decrease in the stress required to maintain that deformation. This mechanical phenomenon is known as:

. Creep
. Stress relaxation
. Hysteresis
. Fatigue
. Anisotropy

Correct Answer & Explanation

. Stress relaxation


Explanation

Stress relaxation is the decrease in stress over time when a material is held at a constant strain or deformation. In contrast, creep is the progressive deformation over time under a constant load.

Question 1645

Topic: Biomechanics & Biomaterials

Which of the following scenarios describes galvanic corrosion in orthopedic implants?

. Micro-motion between the screw head and the plate hole
. Release of metal ions due to a localized drop in pH from infection
. Electrochemical breakdown when two dissimilar metals are in contact within an electrolytic environment
. Fatigue failure of a stainless steel plate after repetitive cyclical loading
. Formation of a passivation layer on the surface of a titanium rod

Correct Answer & Explanation

. Electrochemical breakdown when two dissimilar metals are in contact within an electrolytic environment


Explanation

Galvanic corrosion occurs when two dissimilar metals (e.g., stainless steel and titanium) are placed in direct physical contact within a conductive fluid. The less noble metal undergoes accelerated corrosion acting as the anode.

Question 1646

Topic: Biomechanics & Biomaterials
Highly cross-linked ultra-high molecular weight polyethylene (UHMWPE) is frequently used in total hip arthroplasty to reduce wear. Which of the following mechanical properties is most significantly decreased as a result of the cross-linking process?
. Yield strength
. Elastic modulus
. Fatigue resistance
. Hardness
. Creep resistance

Correct Answer & Explanation

. Fatigue resistance


Explanation

While high cross-linking of UHMWPE significantly improves wear resistance, it detrimentally affects its mechanical properties by decreasing fatigue resistance, ultimate tensile strength, and ductility. This is why highly cross-linked polyethylene is less commonly used in high-stress applications without appropriate thickness or metal backing.

Question 1647

Topic: Biomechanics & Biomaterials

Which type of corrosion is primarily mechanically driven and occurs at the microscopic contact points between modular junctions, such as the head-neck taper in a total hip arthroplasty?

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

Correct Answer & Explanation

. Fretting corrosion


Explanation

Fretting corrosion occurs due to microscopic oscillatory motion between two solid surfaces in contact, causing mechanical disruption of the protective oxide layer. This is classically seen at modular junctions like the head-neck taper of a femoral stem.

Question 1648

Topic: Biomechanics & Biomaterials

On a stress-strain curve for a typical orthopaedic metallic implant, the point at which the material transitions from elastic deformation to plastic deformation is known as the:

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

Correct Answer & Explanation

. Yield point


Explanation

The yield point is the point on the stress-strain curve at which a material ceases to behave elastically and begins to undergo permanent (plastic) deformation. Young's modulus represents the slope of the elastic region (stiffness). Ultimate tensile strength is the maximum stress a material can withstand before failure.

Question 1649

Topic: Biomechanics & Biomaterials

In the stress-strain curve of a ductile orthopedic implant material, the point at which the material undergoes non-reversible plastic deformation but has not yet fractured is best described by which of the following terms?

. Proportional limit
. Yield point
. Ultimate tensile strength
. Failure point
. Endurance limit

Correct Answer & Explanation

. Yield point


Explanation

The yield point marks the end of elastic (reversible) deformation and the beginning of plastic (irreversible) deformation. The ultimate tensile strength is the maximum stress the material can withstand on the curve, and the failure point is where the material fractures.

Question 1650

Topic: Biomechanics & Biomaterials

A surgeon contemplates using a pure titanium plate with 316L stainless steel screws for a fracture fixation. What is the expected electrochemical consequence of mixing these metals?

. Titanium acts as the anode and undergoes rapid corrosion.
. Stainless steel acts as the cathode and undergoes rapid corrosion.
. Stainless steel acts as the anode and undergoes galvanic corrosion.
. Both metals form a stable passivation layer and resist corrosion equally.
. Titanium undergoes fretting corrosion due to decreased yield strength.

Correct Answer & Explanation

. Stainless steel acts as the anode and undergoes galvanic corrosion.


Explanation

When titanium and stainless steel are combined in an electrolytic environment (the human body), galvanic corrosion occurs. Titanium is more noble (cathodic), causing the less noble stainless steel to act as the anode and corrode.

Question 1651

Topic: Biomechanics & Biomaterials

During the correction of a severe scoliotic curve, a surgeon applies an initial distractive force across a pedicle screw construct. Over the next hour, while the displacement remains constant, the tension in the rods gradually decreases. This biomechanical phenomenon is known as:

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

Correct Answer & Explanation

. Stress relaxation


Explanation

Stress relaxation occurs in viscoelastic materials when a constant deformation (strain) is maintained over time, resulting in a gradual decrease in the internal stress (tension). This differs from creep, where continuous deformation occurs under a constant load.

Question 1652

Topic: Biomechanics & Biomaterials

When analyzing the stress-strain curve of a normal human anterior cruciate ligament undergoing tensile testing, what structural event is represented by the initial, non-linear 'toe region'?

. Microfailure of individual collagen bundles
. Plastic deformation of the ligament
. Uncrimping of the resting collagen fibers
. Hydration changes within the proteoglycan matrix
. Macroscopic failure of the ligament tissue

Correct Answer & Explanation

. Uncrimping of the resting collagen fibers


Explanation

The toe region reflects the uncrimping (straightening) of the naturally wavy collagen fibers under low loads. Once the fibers are straight, the ligament enters the linear elastic region of the stress-strain curve.

Question 1653

Topic: Biomechanics & Biomaterials
Manufacturers highly cross-link ultra-high-molecular-weight polyethylene (UHMWPE) using irradiation to improve specific implant properties. What is the primary mechanical trade-off associated with this process?
. Decreased wear resistance with increased fracture toughness
. Increased wear resistance with decreased fatigue strength and fracture toughness
. Increased wear resistance with dramatically increased yield strength
. Decreased oxidation resistance with increased fatigue strength
. Increased plasticity with decreased brittleness

Correct Answer & Explanation

. Increased wear resistance with decreased fatigue strength and fracture toughness


Explanation

Highly cross-linking UHMWPE significantly improves adhesive and abrasive wear resistance. However, it alters the polymer chain mobility, leading to diminished mechanical properties such as fatigue strength, ultimate tensile strength, and fracture toughness.

Question 1654

Topic: Biomechanics & Biomaterials

In orthopedic biomechanics, the pullout strength of a cortical screw is most directly proportional to which of the following design variables?

. Pitch
. Core diameter
. Outer diameter
. Thread depth
. Head diameter

Correct Answer & Explanation

. Outer diameter


Explanation

Pullout strength is directly proportional to the outer (major) diameter of the screw and the total length of engagement in the bone. It is inversely proportional to the pitch of the screw threads.

Question 1655

Topic: Biomechanics & Biomaterials

Which type of corrosion is most likely to occur at the modular head-neck junction of a total hip arthroplasty system, potentially leading to adverse local tissue reactions (ALTR)?

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

Correct Answer & Explanation

. Fretting corrosion


Explanation

Fretting corrosion occurs due to micromotion at the modular taper junction, which repeatedly breaks down the metal's protective passivation layer. This mechanically assisted crevice corrosion leads to the release of metal ions and subsequent ALTR.

Question 1656

Topic: Biomechanics & Biomaterials

In the typical stress-strain curve of a normal ligament, the initial non-linear 'toe region' is anatomically represented by which of the following microstructural phenomena?

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

Correct Answer & Explanation

. Uncrimping of the collagen fibrils


Explanation

The initial non-linear toe region occurs as the resting, wavy (crimped) collagen fibrils straighten out under low loads. Once uncrimped, the ligament enters the linear elastic region where actual stretching of the fibers occurs.

Question 1657

Topic: Biomechanics & Biomaterials
The process of highly cross-linking ultra-high molecular weight polyethylene (UHMWPE) for total joint arthroplasty implants creates which of the following mechanical trade-offs?
. Decreases wear resistance but increases fracture toughness
. Increases wear resistance but decreases fracture toughness
. Increases both wear resistance and fracture toughness
. Decreases oxidation resistance while increasing fatigue strength
. Has no effect on mechanical properties but improves sterilization

Correct Answer & Explanation

. Increases wear resistance but decreases fracture toughness


Explanation

Highly cross-linking UHMWPE with irradiation significantly improves its resistance to adhesive wear. However, this alteration of the polymer chain structure reduces overall mechanical properties, including fracture toughness and fatigue strength.

Question 1658

Topic: Biomechanics & Biomaterials

When selecting materials for a fracture fixation plate, the surgeon must consider the modulus of elasticity to minimize stress shielding. Which of the following implant materials has a modulus of elasticity closest to that of cortical bone?

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

Correct Answer & Explanation

. Titanium alloy


Explanation

Titanium alloys have a modulus of elasticity roughly half that of stainless steel, making it structurally closer to cortical bone. This reduces the risk of stress shielding and subsequent osteopenia under the rigid implant.

Question 1659

Topic: Biomechanics & Biomaterials

A surgeon removes a fractured stainless steel plate that was previously fixed with titanium screws. There is significant dark discoloration and pitting at the specific screw-hole interfaces. Which type of corrosion is predominantly responsible for this finding?

. 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 placed in direct contact within an electrolytic medium like human body fluid. The less noble metal acts as an anode and undergoes accelerated dissolution.

Question 1660

Topic: Biomechanics & Biomaterials

A patient undergoes joint aspiration for an acutely painful, swollen ankle. Microscopic analysis of the synovial fluid under polarized light reveals rhomboid-shaped crystals with weakly positive birefringence. What is the composition of these crystals?

. Monosodium urate
. Calcium pyrophosphate dihydrate
. Basic calcium phosphate
. Cholesterol
. Hydroxyapatite

Correct Answer & Explanation

. Calcium pyrophosphate dihydrate


Explanation

Calcium pyrophosphate dihydrate (CPPD) crystals, characteristic of pseudogout, are typically rhomboid-shaped and exhibit weakly positive birefringence. In contrast, true gout involves monosodium urate crystals, which are needle-shaped and strongly negatively birefringent.