A 55-year-old gentleman, presented with complaints of pain over the left knee joint and inability to weight bear over his left leg for the past ten 10 months. The patient was apparently normal ten10 months ago, when he had a history of slip and fall from 10 feet height at his workplace in the month of January 2017 and sustained close injury to his left knee. The patient developed pain and inability to weight bear over his left leg. The patient initially underwent native splinting for 6 months following the injury. As patient was not relieved of his symptoms following native splinting, patient came to Sri Ramachandra Medical College Porur for further management With complaints of pain, deformity, and unable to bear weight on left leg (Fig.1). There is no history of fever, loss of appetite or any other bone injury. The patient is not a known case of diabetic mellitus, Hypertension hypertension cardiac disease tuberculosis asthma epilepsy. The patient is not a smoker or an alcoholic. Examination revealed left lower limb appears to be shorter than the right lower limb. Muscle wasting was noted over the thigh and calf region. Healed abrasion scar present over the anterior aspect of the knee joint and the distal aspect of the leg. Dilated veins present over the posterolateral and the medial aspect of the knee joint. No popliteal fossa fullness was noted. Tenderness present over medial and lateral jointline Swelling present over the anterior aspect of knee joint. Bony mass is palpable over the anteromedial and lateral aspect of the knee. Broadening and thickening present over the anterior, medial, and lateral aspect of the knee joint. Abnormal mobility was noted. The Range range of Movement movement of the knee was 20 to -70   with fixed flexion deformity of 20 . Further movements were painful. There was no neurovascular deficit noted. Radiographs showed comminuted malunited proximal tibia with depression over the medial condyle 1-2 cm and fracture line extending to the lateral and posterior condyle of tibia (Fig.2). Computed tomography CT of the knee revealed that the whole of the medial condyle was depressed by more than >2 cm and the fracture line was extended into the medial and posterior condyle. (Figs. 3 and 4)). There was no fracture line noted over the metaphyseal region of the shaft of the tibia. Knee joint showed significant osteoarthritis changes. Intraoperatively, we found that the articular cartilage was found to be completely damaged and there was a coronal split of the tibial plateau. The depressed medial condyle was raised and fixed with the help of of cannulated cancellous screw from the medial aspect of the tibia. (Figs. 5 and 6). He was operated upon using a total knee prosthesis - Smith and Nephew Genesis II system with long stem tibial component and cruciate retaining femoral component. Then, appropriate femoral femoral cuts were made and and size 6 left cemented, nonmodular Genesis II cruciate retaining femoral component with Genesis II long slotted stem placed. An appropriate tibial cut made and Genesis II left nonporous tibial base plate placed. Size 5-613mm Genesis II dished articular insert was was placed. Movements of the knee joint were checked intraoperatively and were as found found to be satisfactory. Six 6 weeks postoperatively (Fig. 7), the patient could walk freely without a stick and had no pain. The knee was stable and had a full range of movement.