The Treatment of Periprosthetic Fractures Around the Knee in 2025: A Comprehensive Evidence-Based Approach

Periprosthetic fractures around total knee arthroplasty are associated with significant morbidity and can be difficult to manage because of the presence of implants, compromised bone stock, and patient-specific comorbidities such as osteoporosis. The management of periprosthetic fractures requires a thorough understanding of epidemiology, classification systems, diagnostic approaches, and evidence-based treatment strategies. The treatment strategy is primarily dictated by implant stability and bone quality, influencing the choice between open reduction and internal fixation and revision total knee arthroplasty.