The data of a study published in Orthopaedics & Traumatology: Surgery & Research encouraged the use of total knee arthroplasty (TKA) for reconstruction while treating complex articular fractures due to its lower complication rates and improved functional outcomes.

Arthroplasty is commonly used to treat the acute fracture of the proximal femur, elbow fracture but is less usual in complex knee fracture. The arthroplasty was done with an objective to save the patient’s life by limiting the decubitus complications. Internal fixation or even nonoperatively treat most complex knee fractures in the elderly. There are, however, good reasons, in the knee as much as for hip or shoulder fractures, for treating certain acute complex fractures using an arthroplasty. Therefore, in the present study Parratte S et al hypothesis that knee arthroplasty could be a solution for acute fractures around the joint in elderly osteoporotic patients.

Preoperative planning is much needed, to manage the appropriate materials required for intraoperatively. The basis of a surgical treatment requires to consider factors like bone defect management, choice of implant, implant fixation, and steps of reconstruction. For fractures of the distal femur, the first temporary reduction is a useful method to evaluate the rotation of femoral and level of the joint line. In the diaphyseal extension of the fracture, complementary internal fixation may be required to prevent inter-prosthetic fractures. 

In the literature, the results of primary total knee arthroplasty TKA for fracture are encouraging  over arthroplasty following conservation therapy due to the benefits it dispenses such as earlier full weight-bearing, lower revision incidence, reduced complication rates and improved functional outcomes. However, a frequent reduction in autonomy with higher 1-year mortality, following complex femoral fractures was seen in the elders. Therefore, the treatment requisite enticing knowledge, huge experience of principles of prosthetic revision and optimized logistic preparations and proper planning.