This case study uses the Technological Pedagogical Content Knowledge (TPACK) framework to describe how teachers from two contiguous school districts in southwest Virginia implemented "The CandyFactory," an iPad-specific learning game that focuses on pre-algebraic concepts, particularly fraction knowledge. As a result of this implementation, significant changes in practice and instruction took place for these teachers and their students. The goal of this paper is to exemplify the most salient changes that took place, using the TPACK framework and seven knowledge areas. Through a series of focus group interviews with nine teachers and an interview with a program administrator from three middle schools in two districts, findings of this study illustrate how the main and interconnected types of knowledge of the TPACK framework could be used to evaluate the affordances and constraints of a learning game implementation and how it affected the content and pedagogical styles of teachers in the classroom. Using an interpretative research methodology, complemented by quantitative pre-/post-assessments of fraction achievement, data from these interviews were collected and analyzed, using a coding system to identify patterns and themes regarding best practices for instructional alignment as well as shifts in instruction, assessment, and pedagogical styles. As part of the special issue, the case study includes a series of recommendations and implications that could be relevant to similar school districts, including those in the Asia Pacific region, that are considering the adoption of game-based learning and implementing these types of mathematical learning games in classrooms to enhance engagement and performance.