Floating Knee is the term applied to the flail knee joint segment resulting from a fracture of the shaft or adjacent metaphysis of the ipsilateral femur and tibia The fractures range from simple diaphyseal to complex articular types. The word floating knee was introduced for the first time by Mc Bryde in 1965. The incidence of these injuries is increasing. They are associated with potentially life threatening injuries of the head, chest, and abdomen. Not less frequently these injuries cause infection, excessive blood loss, fat embolism, mal union, delayed or non-union, knee stiffness, prolonged hospitalization, and inability to bear weight. Malunion is one complication which drastically affects the functional outcome. Hence we tried to find the factors that may result in malunion more often than not which will help to prepare us in a more suitable manner in treating these injuries We analysed 30 cases of floating knee which were surgically treated regarding the pattern of injuries, type of injuries, closed/open, fixation methods, associated injuries, union rates, malunion and functional outcome. All cases were followed up to a minimum of 1 year. We found that malunion in a floating knee injury which was surgically treated drastically affected functional outcome. The mechanism of injury, type of fracture, open/closed injury, level of fracture whether diaphyseal or juxta articular or intraarticular, type of initial fixation all had a significant correlation with occurrence of malunion.

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<p class="abstract"><strong>Background: </strong>Osteoarthritis and rheumatoid arthritis affects all patients of age more than 50 years, requiring total knee replacement. There are two major approaches to total knee replacement- sub-vastus approach and medial parapatellar approach. There is no common consensus on superiority of sub-vastus approach. So, we undertook the present study to evaluate the functional and clinical outcome of total knee replacement via sub-vastus approach in terms of knee society clinical and functional scores and visual analog scale along with monitoring of range of motion in the post-operative knee in the follow up period.</p><p class="abstract"><strong>Methods: </strong>The present prospective and observational study was conducted in the Department of Orthopaedics, Unique Super Speciality Hospital, Indore, Madhya Pradesh for a period of 12 from June 2019-May 2020 with sample size of 30 patients undergoing total knee arthroplasty. All the patients had undergone total knee replacement via sub-vastus approach. The functional and clinical results of our study were compared with available literature.</p><p class="abstract"><strong>Results:</strong> The mean KFS and KCS scores showed a statistically significant improvement over a period of 12 months (p&lt;0.05), while the mean ROM showed an improvement till 6 months (p&lt;0.05) and then it remained stable till 12 months in comparison to 6 months (p&gt;0.05).</p><p class="abstract"><strong>Conclusions: </strong>On comparing the results of sub-vastus approach with the available literature we found a significant improvement in functional and clinical outcome with a stable improvement in range of motion with very few complications.</p>

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