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Infections and periprosthetic fractures are uncommon but dreaded complications of total knee arthroplasty which carry attendant morbidity and prolonged hospitalization and necessitate repeat surgery. We present a patient with a total knee arthroplasty who had both intra-operative and post-operative periprosthetic fractures who subsequently developed infection of the prosthesis necessitating revision surgery. This was complicated too by positive intra-operative tissue cultures. The clinical course, presentation and management are discussed. Total knee arthroplasty is a frequently performed and successful operation and its complications are challenging to address and require early recognition by the surgeon with appropriate referral to a dedicated arthroplasty surgeon as needed.