Osteoarthritis of the knee is a degenerative row disease that can be caused by a variety of causes. During its slow onset, the lesions progress at varying rates, sometimes exhibiting rapid inflammatory changes, sometimes chronic inflammatory extension, and even sometimes stable remission. Most scholars now believe that the destruction of articular cartilage in this disease is often irreversible, and that medical measures can slow down the rate of articular cartilage destruction but cannot change the trend and direction of this pathological change. This disease induces inflammation of the synovial membrane and other soft tissues due to the destruction of articular cartilage. First, the soft tissue damage around the knee joint causes adhesions and strains, which disrupt the force balance of the knee joint and create high stress points within the joint. There are many clinical causes of pain and swelling in the patient’s knee, but soft tissue inflammation is the main factor. Therefore, in this sense, relieving or eliminating the inflammation of the soft tissues of the knee joint will reduce or remove the symptoms of pain and swelling in the knee. The principle of acupuncture is “pain is Yu”, and most of the acupuncture points are located around the patella, the medial joint space, the tibial tuberosity, and the N fossa, all of which are actually soft tissue inflammation gathering areas. The needles mainly focus on excision and stripping, deep to the bone surface but try not to enter the joint cavity to avoid causing local bleeding, which can break the vicious cycle of inflammation, improve the blood metabolism of soft tissues, and relieve or eliminate local inflammation. Strictly speaking, small needle knife treatment for knee osteoarthritis is not etiological treatment, but it has a certain effect of relieving soft tissue inflammation in the knee. Therefore, it has an important role in clinical practice.