In total knee arthroplasty, the status of the soft tissue around the knee joint is important in preventing soft tissue complications and post-operative infection to obtain good results. This article reports a patient, who presented with a stiff knee joint and poor soft tissue coverage as a consequence of several operations after an open patellar fracture. The patient underwent total knee arthroplasty after an expansion of the skin and adjacent soft tissue using a tissue expander. The TKA results were satisfactory without any soft tissue complications including infections or skin necrosis.