Fractures of the distal femur, proximal tibia, and patella that occur adjacent to a total knee replacement may be very difficult to treat. Fixation options are compromised because of the short articular segment, frequent comminution, pre-existing osteoporosis, previous surgical incisions, and the presence of the knee implant itself. This review article summarizes current concepts regarding the incidence, classification, treatment options, and outcomes for periprosthetic fractures of the knee.

Further research is needed to determine if fat and bone-marrow-debris embolization is truly decreased by the use of computer-assisted total knee arthroplasty and if such a reduction has any clinical relevance.