Periprosthetic fractures of the femur complicating total knee arthroplasty.

Fractures of the femur in the presence of a total knee arthroplasty may occur intraoperatively or postoperatively. Management of these fractures is often challenging because of a variety of factors, including those related to the fracture itself, and the quality of the bone, prosthesis, and patient. Treatment options include nonoperative methods, reduction and internal fixation, and revision of the arthroplasty. Complications of treatment are not uncommon and may be severe. These issues are discussed in the article.