Periprosthetic fracture around the knee is the most common one among all periprosthetic fractures, and supracondylar fracture of the femur is the most common type around the knee. Unfortunately, the one-year mortality rate after a periprosthetic fracture is very high, reaching 25%. While osteoporotic fracture fixation is already difficult, the management of these fractures remains a challenging problem because of associated osteoporosis, devascularization of the bone from the previous arthroplasty surgery, and medullary canal filling prosthesis. The treatment aim is rapid mobilization of the patient with a friendly soft tissue surgery, good reduction, and stable fixation. The objective of this article is to review the treatment principles of this type of fractures.