Addressing the Periprosthetic Fracture About the Distal Femur: Loose or Well-Fixed?

Periprosthetic fractures remain common complications after total knee arthroplasty with the distal portion of the femur representing the most common location of fractures. The increasing number of total knee replacements being performed brings more attention to this problem. Evaluation of bone stock and implant fixation is a big part of the challenge of this fractures. For this reason, a breadth of techniques and systems for treatment of this complication are in constantly development. This chapter will synthesize options for management of distal femoral periprosthetic fractures above a total knee arthroplasty, focusing on pearls and pitfalls of the technique, with illustrative cases.