This 1999 review by Rorabeck and Taylor surveys and compares classification systems for periprosthetic fractures around total knee arthroplasty — supracondylar femoral, tibial, and patellar — describing how each system organizes fractures by location, displacement, prosthetic stability, and extensor mechanism integrity to guide surgical decision-making.
When you see a periprosthetic knee fracture on postop films, immediately assess two things: is the fracture displaced, and is the implant stable? A loose or failing prosthesis (Lewis-Rorabeck Type III, Felix type 'b') means revision — not ORIF. Regardless of fracture pattern; the same logic applies to patellar fractures where Goldberg Type II or IIIa disruption of the extensor mechanism or implant interface demands operative intervention.
This 1999 review by Rorabeck and Taylor surveys and compares classification systems for periprosthetic fractures around total knee arthroplasty — supracondylar femoral, tibial, and patellar — describing how each system organizes fractures by location, displacement, prosthetic stability, and extensor mechanism integrity to guide surgical decision-making.
When you see a periprosthetic knee fracture on postop films, immediately assess two things: is the fracture displaced, and is the implant stable? A loose or failing prosthesis (Lewis-Rorabeck Type III, Felix type 'b') means revision — not ORIF. Regardless of fracture pattern; the same logic applies to patellar fractures where Goldberg Type II or IIIa disruption of the extensor mechanism or implant interface demands operative intervention.