Osteoarthritis has been the major cause of knee pain in the society from long. Although patients are taking medicines, still they are facing knee pain a lot. Total knee arthroplasty is the only measure to deal with these paining situations. An adverse effect of total knee arthroplasty is persistent knee pain. Therefore study are to analyze and treat that muscular imbalances causing painful knee after total knee arthroplasty. In this study data from single case, 64 years old female, was used in physiotherapy clinic. She was having persistent knee pain after total knee arthroplasty. That was not resolved 34 months after surgery.She felt knee pain constantly and it became aggravated during any stressful or weight bearing activities. Patient was assessed and analyzed for having cause of their knee pain. Muscular and other dysfunctional issues were found at the time of assessment. Resultant mechanical changes led to the mal-alignment and instability of knee joint. In this study, some physical therapeutic approaches were applied. Patient got relieved after physical treatment up to the mark. Thusadequate physical evaluation of patient’s related problems before treatment is mandatory. Furthermore other mechanical causes also need to be analyzed. These factors can be used to help in reduce the incidence of persistent pain after total knee arthroplasty. If actual physiotherapeutic applications are applied on the basis of clinical findings regarding biomechanical changes, these biomechanical abnormalities could be treated with ease. Thus unnecessary revision surgeries could be avoided for knee pain after total knee arthroplasty. Therefore overloading of healthcare system might be reduced. And excessive financial burden over the society can be avoided as well.