Nothing shoulder fired will actually knock one down. Cause them to fall down, yes. Unless you hit the central nervous system it's wrecked innards causing them to expire. A 95 grain Ballistic Tip wrecks deer innards nicely, as does the 95 grain SST in my experience. My nephew has downed a few with the 95 SST and we haven't caught a bullet yet.

There are others on these boards who have a lot more 243 experience. I was a late comer to the cartridge, for years it was too small for my taste.