Degenerative joint disease is known to occur in patients with a history of polio. However, minimal or absent quadriceps function is generally considered to be a contraindication to total knee arthroplasty. We describe an elderly patient with quadriceps paralysis secondary to poliomyelitis who underwent a successful total knee replacement for severe osteoarthritis. The primary operative indication was disabling pain. At the 1-year follow-up the patient reported excellent pain relief, and there were no clinical or radiographic signs of deformity.