Knee replacement is an effective treatment for pain and functional impairment secondary to degenerative joint conditions. The number of knee replacements performed continues to rise. Periprosthetic fractures around total knee arthroplasties are a relatively rare complication but are complex injuries that require the treating surgeon to be familiar with and proficient at arthroplasty and trauma reconstructive techniques. An increase in life expectancy and in the functional demands of elderly patients may lead to an increased incidence of periprosthetic fractures. Supracondylar fractures of the femur are the most common type and this review will focus on the incidence, risk factors, classification, investigation, and treatment options for periprosthetic fractures around total knee arthroplasties.