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A 78-year-old man sustained right knee dislocation in a fall. His pain was diminished on account of his past history of tabes dorsalis due to neurosyphilis, resulting in delayed hospital attendance for a week. The injury was posterolateral rotatory dislocation of the knee. Since closed reduction was not possible, open reduction was performed. Most cases of knee joint dislocation are easy to reduce. However, it is difficult to conduct closed reduction in this type of dislocation, because the joint capsule and medial collateral ligaments are torn by the medial femoral condyle. It is important to recognize that some types of dislocation of the knee are difficult to reduce.