With the diversity of prosthetic components patients with a transtibial amputation can now expect to return to high function. Subsequently, the ipsilateral knee is at risk of developing osteoarthritis with a need for a provision of total knee arthroplasty (TKA).We describe a novel technique for TKA in a transtibial amputee utilizing navigation with a tibial jig. Post-operative radiographs revealed varus tibial alignment with neutral limb alignment. Resolution of stump swelling allowing accurate prosthesis fitting was seen at 8 weeks. A new prosthesis optimized functional alignment and a return to moderate labor was achieved at 10 weeks. At 1-year postoperatively, patient satisfaction was excellent.Navigation alongside stump alignment is a useful technique. We found that after socket fitting, radiographic tibial varus alignment can correspond with a stump position that allows balanced loading of the knee and excellent function.