The current treatment for knee osteoarthritis mainly includes pharmacological, non-pharmacological and surgical treatments. Commonly used drug treatments include non-steroidal anti-inflammatory painkillers, sodium glutamate, chondroprotective agents, etc. Non-pharmacological treatments include exercise therapy, acupuncture, internal and external application of Chinese herbs and physical therapy. Although long-term clinical application of anti-inflammatory and analgesic drugs can improve joint pain, the underlying pathological changes of knee OA will be aggravated, coupled with the analgesic effect of non-steroidal anti-inflammatory drugs, joint pain disappears, leading to joint overuse aggravating cartilage damage surgical treatment is indicated for late lesions. In recent years, other conservative treatments for knee osteoarthritis, including acupuncture and small acupuncture, have been recognized and favored by many clinical practitioners and patients. Manipulative treatment of knee osteoarthritis has been sidelined, but in fact, manipulative treatment of knee osteoarthritis is not only effective, but can also be as effective as other treatment methods. Although there are many ways to treat knee osteoarthritis, they generally include the following in summary: (1) Pressing the muscles and tendons around the knee joint and other soft tissues (focusing on the medial head of the quadriceps; flicking the medial and lateral tendons of the knee joint with the thumb and using the roll method to do relaxation techniques along the medial and lateral muscles of the lower extremity). (2) Pointing and clearing the meridians (including pointing and pressing the knee eyes, Liangqiu, Blood Sea, Heting, Zhizhong, Feosanli, Yanglingquan, Yinlingquan and other points). (3) Finger plucking the hip bone (holding the outer upper corner of the patella with the thumb and plucking the patella rhythmically from the outside to the inside, then pushing and pressing the patella in the up-and-down direction; then grasping the patella with the five fingers, lifting it upward rhythmically and pinching the infrapatellar joint surface with the fingertips to loosen the patellofemoral joint). (4) Passive movement of the knee joint. Previously, the main pathological changes of osteoarthritis of the knee were thought to be cartilage degeneration and synovial inflammation. Later, scholars found elevated intraosseous pressure and venous stasis. There is no unanimous opinion. Some believe that the cartilage degeneration products stimulate synovial inflammation and increase exudation causing increased intra-articular pressure and consequently intraosseous hypertension, which affects the blood flow to the bone and joint. Others believe that intraosseous hypertension is caused by chronic intraosseous venous stasis. On the one hand, intraosseous pressure and venous stasis reduce intraosseous arterial perfusion and venous return, resulting in insufficient oxygen supply and lower PH; on the other hand, it decreases synovial blood flow and increases acidic synovial fluid secretion, and the acidic changes in subchondral bone and synovial fluid cause the release of neutral proteases that reduce cartilage proteoglycans in the tissues, resulting in damage to articular cartilage. Most of the patients with this disease clinically see varicose veins in the lower extremities, and high tibial osteotomy treatment of this disease can make the internal pressure decrease, joint swelling and pain relief, but also can make the thigh varicose veins disappear, etc., which all indicate that the formation of intraosseous venous stasis is closely related to the lower extremity venous reflux disorder. In addition, the knee pain seen clinically is not consistent with the x-ray presentation, but is closely related to the intraosseous hypertension. We believe that the above pathological factors interact with each other. Therefore, the treatment requires active elimination of all pathological factors in order to achieve therapeutic effect. The treatment method can “disperse blood qi”, “to heat qi”, “open meridians”, “collect plagiarism” (Nei Jing), and “correct tendon position” (Nei Jing). It can “correct the position of tendons” (Jinjian of Medicine). According to a recent scholar, Zheng Huaixian, tui na can “move qi and activate blood, unblock the meridians, harmonize Ying and Wei, balance the internal organs, and warm the meridians”. Chinese Tuina techniques focus on bone movement and soft tissue release, with bone movement being the main focus, and on releasing the adhesions of soft tissues around the knee joint. The action of the manipulation on the affected area can make the capillaries dilate and open, improve local blood circulation, promote lymphatic circulation and edema, increase the nutrient supply to the muscles and nerves, strengthen the absorption pump of the cartilage tissues themselves, relieve muscle spasms, anti-inflammatory and analgesic, thus further improving the function of the knee joint and the gradual absorption of joint effusion. In addition, the knee joint can be released from adhesions, widen the joint space and smooth the joint by knee knee knee knee massage and passive flexion and extension. In conclusion, the treatment of osteoarthritis of the knee joint by manipulation not only promotes local blood circulation and metabolism, but also facilitates the absorption of inflammation and tissue repair in the joint cavity, while reducing intra-articular pressure, loosening joint adhesions, changing the narrow joint space, avoiding excessive stimulation and friction, and reducing cartilage degeneration, thus eliminating or relieving pain and improving clinical symptoms. It is worth mentioning that many patients of younger age are found to have knee pain and walking weakness due to wearing shorts and skirts for a long time and working in an air-conditioned (cold) office environment, but there is no specific manifestation on knee x-ray. This group of patients is increasing with the change of working environment, obviously they can not meet the diagnostic criteria of knee osteoarthritis, but the need for treatment is certain, and personal clinical experience shows that this group of people is treated with good results by manipulation. Further research is warranted.