Periprosthetic fracture: Femoral and patellar fractures are more common than tibial fractures. The aim of supracondylar fracture femur treatment is to achieve fracture union within 6 months, with minimal displacement (< 5 mm translation, < 5 degree mediolateral and < 10 degree anteroposterior angulation, < 10 degree rotation, < 1cm shortening) with range of motion at least 90–100 degree. Locking compression plate is the best option. Infection is disaster for TKR. Diabetic and Rheumatoid arthritic patients are more prone to infection. Once infection is confirmed, the joint should be opened at the earliest. Persistent serous discharge for more than 5 to 7 days is an indication for surgical exploration and debridement. Late infections are more common than early infections and are usually due to haematogenous spread of microorganism from a distant site. Prosthetic retaining procedures are more likely to be successful in early infections while late infections require prosthetic removal and exchange. Knee arthrodesis may be required when destroyed bone or soft tissues may make implantation of another prosthesis very difficult following the staged treatment of an infected total knee arthroplasty.