Periprosthetic fractures around the knee

Background Periprosthetic fractures of the knee joint are complex injuries and frequently represent a challenge for the surgeon. Objective The aim of this review is to present and discuss the current classification and treatment options for periprosthetic knee fractures. Material and methods A selective review of the existing literature on periprosthetic fractures around the knee was performed in PubMed. The various classifications and treatment regimens are discussed with respect to the advantages and disadvantages and from this knowledge a new algorithm was developed. Results The classifications of periprosthetic fractures have changed in recent years and have been replaced by a uniform fracture classification; however, not only the radiological evaluation of the fractures is crucial to determine the treatment regimen for periprosthetic fractures. A thorough evaluation of the inserted endoprosthesis should be carried out in order to be able to decide between the treatment options of osteosynthesis and revision arthroplasty. Treatment options are available for osteosynthesis and revision arthroplasty that enable a safe treatment of these complex injuries. Conclusion Periprosthetic fractures of the knee joint are complex injuries, requiring a thorough preoperative planning and an interdisciplinary treatment with trauma and endoprosthetic expertise.