Management of periprosthetic fracture above total knee arthroplasty using intramedullary fibular allograft and plate fixation.

We report a series of comminuted periprosthetic fractures above total knee arthroplasties in 3 patients who were treated by using an intramedullary fibular strut allograft and a lateral buttress plate. The patients, whose ages ranged from 74 to 90 years, were grossly osteopenic on radiographs. All 3 fractures healed in a satisfactory alignment without any complications. We believe this technique is a feasible treatment option for periprosthetic fractures in this difficult group of patients, having both biologic and mechanical advantages.