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Periprosthetic fractures after total knee arthroplasty are notoriously challenging entities to manage. The 2 major fixation techniques utilized include locking compression plates and retrograde intramedullary nailing. The challenges in obtaining correct entry points in the presence of the superimposing femoral component in retrograde intramedullary nailing often warrants a full knee joint arthrotomy. Thus, the purpose of this first series is to describe the arthroscopy-assisted retrograde intramedullary nailing (ARIN) technique and eval