title: Fracture of a spline of the femoral stem in an ingrown modular hip implant.
abstract: BACKGROUND
  Physiologic strain patterns of the femur are altered by the bending stiffness of the implant as well as the loading pattern of the implant itself. The Savish Range of Motion (S-ROM) femoral stem has been designed with flutes (to decrease distal material) and with a coronal slot (to decrease stiffness).
  
  
  METHODS
  The purpose of this case report is to briefly discuss design characteristics of femoral stems and their relationship to thigh pain as well as to describe the only report in the literature of a fracture of the anterior spline of a S-ROM prosthesis at the coronal slot.
  
  
  RESULTS
  The femoral stem fractured at the coronal slot due to multiple bending moments in a small diameter stem.
  
  
  CONCLUSIONS
  The proximal metaphyseal sleeve remains well fixed and the patient is functioning well without pain nearly a year after the identification of the fracture on routine follow-up.
authors.affiliation: Colorado Joint Replacement, Denver, Colorado - USA.|Raleigh Orthopaedic Clinic, Raleigh, North Carolina - USA.
authors.forename: David Clinton
authors.initials: DC
authors.lastname: McNabb
authors.affiliation: Colorado Joint Replacement, Denver, Colorado - USA.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Jennings
authors.affiliation: Colorado Joint Replacement, Denver, Colorado - USA.|Department of Biomedical Engineering, University of Denver, Denver, Colorado - USA.|Department of Biomedical Engineering, University of Tennessee, Knoxville, Tennessee - USA.|Department of Orthopaedics, University of Colorado Health School of Medicine, Aurora, Colorado - USA.
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Dennis
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D015207:Osteoarthritis, Hip / Q000601:surgery; D010149:Postoperative Pain / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D011474:Prosthesis Design / Q000009:adverse effects; D011475:Prosthesis Failure / Q000009:adverse effects; D016059:Range of Motion, Articular; D012086:Reoperation