الفهرس 
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Abstract
In this essay, we try to gave an idea about the periprosthetic fractures of the hip and knee , and
the most recent ways to manage them .
The important points will be summarized to help surgeons dealing with these fractures .
In the acetabular region at the time of operative treatment of periprosthetic fractures, the
surgion must be prepared to use reconstruction plates, bone grafting and acetabular reconstruction
rings.
Periprosthetic fractures of the femur are difficult treatment problemes requiring thorough
preoperative planning and availability of specialized implants as especial plates and wires ,cables
and allografts or revision implants with long stem. There are many factors to be considered ,
including the premorbid condition of the patient , important factors related directly to the
fracture including the sit , stability of the implant , and the state of the surrounding bone stock
. The use of cortical onlay strut allografting may be expanded to augment other treatment regimens
in which they serve to improve overall stability and bone stock
Fractures usually occur in the supracondylar region of the femur. Most of these fractures should be
treated with internal fixation except undisplaced or minimally displaced fractures which are
treated with nonoperative methods if the fracture is stable there are no contraindications to
conservative treatment.
Many treatment options can be used like condylar plates, intramedullary supracondylar nails,
revision arthroplasty, and custom made endoprosthesis .
Periprosthetic tibial fractures in the sitting of loose prosthesis are
best managed by early revision arthroplasty with appropriate fracture fixation. Insertion of a
stemmed tibial component and bone grafting of the fracture site are usually sufficient.
Fractures associated with a well fixed prosthesis can be treated with closed reduction and casting.
Restoration and maintenance of limb alignment is of critical importance.
Patellar fractures associated with total knee replacement are uncommon.
Patellar fractures requiring operative treatment often yield unsatisfactory results. Prevention is
the best treatment and includes proper total knee replacement alignment, soft tissue balancing,
patellar
height restoration, and implant selection.