Periprosthetic fractures around the knee are challenging complications following total knee arthroplasty. They can occur in the distal femur, tibia, or patella. Evaluation involves assessing fracture pattern, implant stability, and patient medical status. Treatment depends on fracture type but may include open reduction and internal fixation, retrograde nailing, or revision arthroplasty. Close postoperative monitoring is important as complications like nonunion and infection can approach 10-15% rates. Careful surgical planning and experience managing these fractures is important for optimal outcomes.