title: Periprosthetic fractures around total knee arthroplasty.
abstract: BACKGROUND
  The number of total knee arthroplasties performed continues to rise annually and it would be expected that complications, which include periprosthetic fractures, will also therefore become more commonplace. This article reviews the current literature regarding this injury  and identifies the treatment principles that enable patients to regain optimal function.
  
  
  METHODS
  A comprehensive search of the Pubmed and Embase™ databases was performed to identify relevant articles. Keywords and MeSH (Medical Subject Headings) terms included in the search strategy  were 'periprosthetic fracture(s)', 'femur', 'tibia', 'patella(r)', 'complication(s)', 'failure(s)', 'risk(s)', 'prevalence', 'incidence', 'epidemiology' and 'classification(s)'. The search was limited to all articles published in English and reference lists from the original articles were  reviewed to identify pertinent articles to include in this review. A total number of 43 studies were identified.
  
  
  RESULTS
  Common treatment aims have been identified when managing patients with a periprosthetic fracture around total knee arthoplasty. The main criterion that determines which  option to choose is the degree of remaining bone stock and the amount of fracture displacement.
  
  
  CONCLUSIONS
  Treatment of a periprosthetic fracture around total knee arthroplasty will either be non-operative, osteosynthesis or revision arthroplasty. It is imperative that a suitable option  is chosen and based on the published literature, pathways are outlined to aid the surgeon.
authors.affiliation: Department of Orthopaedic Surgery, University College Hospital, 235 Euston Road, London NW1 2BU, UK. ridhisarmah@gmail.com
authors.forename: S S
authors.initials: SS
authors.lastname: Sarmah
authors.forename: S
authors.initials: S
authors.lastname: Patel
authors.forename: G
authors.initials: G
authors.lastname: Reading
authors.forename: M
authors.initials: M
authors.lastname: El-Husseiny
authors.forename: S
authors.initials: S
authors.lastname: Douglas
authors.forename: F S
authors.initials: FS
authors.lastname: Haddad
mesh_terms: D019645:Arthroplasty, Replacement, Knee; D005264:Femoral Fractures / Q000209:etiology; D006801:Humans; D007720:Knee Prosthesis; D010329:Patella / Q000293:injuries; D057068:Periprosthetic Fractures / Q000209:etiology* / Q000628:therapy; D012086:Reoperation; D012307:Risk Factors; D013978:Tibial Fractures / Q000209:etiology