Knee dislocations are rare injuries caused by violent trauma. Damage to soft tissues and ligament lesions almost always accompany the injury. Vascular compromise further complicates the situation. We report a case of bilateral posterior knee dislocation with traumatic rupture of both patellar tendons. Treatment consisted of external fixation of both knees. Vascular compromise resolved with reduction and traction pins were placed on both patellae which were connected to the external fixators on following days. Primary repair of patellar tendon was undertaken after gradual distal repositioning of patella. The result is successful with full range of motion. Rupture of patellar tendon should be considered with posterior dislocation of the knee. External fixators provide quick stabilization in case of vascular compromise and can be modified to provide a traction system for distal repositioning of patella which allows primary repair of the patellar tendon. (C) 2006 Elsevier B.V All rights reserved.