Periprosthetic fractures of the tibia and patella in total knee arthroplasty.

Periprosthetic fractures of the tibia and patella associated with total knee arthroplasty are less common than periprosthetic fractures of the distal femur and therefore have been less frequently reported in the literature. Because more total knee replacements are now being performed and implant and patient survival has improved, periprosthetic fractures of the tibia and patella may be recognized more frequently in association with both primary and revision total knee replacement. Several risk factors associated with both types of fractures have been identified, and addressing patient factors, surgical techniques, and implant designs that may contribute to increased risk is an important aspect of management.