Periprosthetic fractures around the knee: update on therapeutic algorithms for internal fixation and revision arthroplasty.

Effective treatment of periprosthetic fractures following TKA continues to represent a surgical challenge. The incidence and frequency of these complicated type of fractures is expected to increase as the number of TKA as well as the activity level of these patients steadily rises. A careful and correct analysis of the fracture pattern, its classification, the quality of the existing bone stock and the fixation / loosening of the underlying prosthetic system has to precede decision making for successful conservative or surgical treatment. Therefore, improved diagnostic radiographic imaging of fracture patterns and reliable assessment of prosthesis loosening progressive development of new implant methods and refinement of soft tissue preserving surgical techniques will hold the key for regaining the functional level prior to the fracture.