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Background: Above knee amputations can result from a failed total knee arthroplasty. The functional outcomes of amputees who have had a failed total knee arthroplasty are poor. The purpose of this case report is to describe the physical therapist management of a highly active individual with an above knee amputation following a failed total knee arthroplasty. This case report aims to discuss key elements that should be included in rehabilitation for optimal mobility and outcomes with a prosthetic limb. Case Description: The patient is a middle-aged male veteran who was referred to physical therapy after undergoing an above knee amputation after a failed total knee arthroplasty. Intervention: Physical therapy focused on reducing phantom limb pain and preparing the residual limb for prosthetic use, gait and balance training, and treadmill training using a body weight supported treadmill. Outcomes: The patient was functional with his prosthetic limb and able to walk community distances using an assistive device. He had improved his score on the RiverMead Mobility Index and met all PT goals. Discussion: This case report demonstrates a positive example of the physical therapist management of an above knee amputee following a failed total knee replacement.