After major trauma of the knee joint, conservation and reconstruction of the different bony, ligamentary and soft tissue structures is usually attempted. The end results of these reconstructive procedures are not always gratifying, and in many cases significant instability remains, combined with severe restriction in motion, pain or infectious problems, leading to severe functional impairment. Many patients need secondary corrective procedures, such as arthrodesis. We present a case of an unusual injury to the knee with massive destruction, loss, and contamination of bony, ligamentary, and soft tissue structures. Because attempts at reconstruction would have led to the above-mentioned problems, including possible life-threatening septic complications necessitating amputation, a primary arthrodesis was performed, followed by simple reconstruction of the soft tissue envelope. Two years after the accident, the patient is doing very well. To our knowledge, no such cases have previously been described. We therefore want to communicate our experience with this procedure, which led to an early, pain free, and good functional recovery.