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When elder arthritis patients suffered from complex supracondylar femoral fractures, their joints condition and general health condition elevate the difficulties in operation and post-surgical recovery.Here, we aimed to simplify the operation procedure by using one-step Total Knee Arthroplasty (TKA) with a stemmed femoral implant. We also investigated if this method could improve the patients’ experience after the operation. The surgery including femoral osteotomy and implantation was performed on all fourteen patients by the same orthopedic specialist. The patients’ hospitalization time was recorded. The recovery of knee function and patient satisfaction was evaluated by a systematic follow-up with average time 38 months, up to 5 5 years, using Hospital for Special Surgery (HSS) knee scores, the range of motion (ROM), anteroposterior and lateral radiography, and Visual Analog Scale (VAS) scores. The average of hospitalization days was 16 days. No angular deformity, malunion, or shortening were found at radiography.The average ROM was 105.2° at the end of the follow-up period. The knees in all the patients show adequate stability. All patients had returned to their former daily activities. Seventeen out of 24 patients were satisfied with the outcome of the surgery.The usage of TKA with a stemmed femoral implant is a reasonable method for elderly patients suffering from supracondylar femoral fractures and concomitant knee arthritis.