The knee is one of the most common sites of osteoarthrosis. The current consensus understanding of knee osteoarthritis (knee OA) is a process of degenerative changes in joint cartilage due to one or several causes that are not known, with pain and swelling as the main complaints of clinical visits, which seriously affects the patient’s motor function. Small needle knife therapy is an important part of Chinese medicine, in recent years, under the guidance of the basic theory of Chinese medicine, absorb modern medical knowledge, the use of small needle knife treatment of osteoarthritis of the knee, received certain efficacy. 1, bilateral patients, the severe side as the treatment, observation The other side is supplemented with manipulative treatment. The original data before and after treatment were collected before admission to the hospital, 1 week, 2 weeks and 4 weeks after treatment. All cases were treated with small needle knife. 2. METHODS The patient was placed in the prone position with the knee joint in extension or, if there was a flexion deformity, with a pillow in the N-fossa. The operator wears sterile gloves, and the patient’s knee skin is routinely disinfected with iodine and alcohol, and a towel is laid. Two to three ayurvedic points were identified in the peripatellar region, lateral collateral and patellar ligament attachments, and the N fossa. 1% lidocaine was used for skin anesthesia, and the knife was entered with a small needle incision line parallel to the direction of the tendon fibers. Longitudinal stripping was the main focus, supplemented by transverse stripping, and the knife was exited along the original path after obvious loosening under the knife. Dressing is applied and the area is kept dry for 2 days to avoid strenuous activities. The full course of treatment includes 2 to 4 times depending on the condition, with an interval of one week. 3. Clinical significance of relieving the symptoms of knee osteoarthritis (1) Knee osteoarthritis is a degenerative line disease that can be caused by a variety of reasons. In its slow onset, the lesion progresses at different rates, sometimes showing acute 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. The disease induces inflammation of the synovial membrane and other soft tissues due to the destruction of articular cartilage. 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 can reduce or remove the symptoms of pain and swelling in the knee. Small acupuncture therapy is a part of Chinese medicine acupuncture, which has a better effect on pain and swelling because of its effect of moving qi and blood, and opening meridians and channels. In the treatment of osteoarthritis of the knee, the principle of acupuncture points is “pain is Yu”, and the acupuncture points are located around the patella, the medial joint space, the tibial tuberosity, the N fossa, etc. These points are actually soft tissue inflammation gathering areas. The needle method is mainly based on incision and longitudinal stripping, deep to the bone surface but try not to enter the joint cavity, to avoid causing local bleeding, to incision and stripping inflammation of the synovial opacities and tendon attachment sites of inflammatory masses, can break the vicious cycle of inflammation, improve the blood metabolism of soft tissue, relieve or eliminate local inflammation. Strictly speaking, small needle knife treatment for knee osteoarthritis is not an etiological treatment, but it has a certain effect of relieving soft tissue inflammation in the knee. Therefore, it has a positive role in clinical practice. (2) The effect of small needle knife on pain and swelling The effect of small needle knife on pain: there is a significant relief effect before and after treatment, and the degree of pain gradually decreases with the increase of the number of treatments within a certain period of time, but there is no significant difference between the effect of treatment for 2 weeks and treatment for 4. Knee pain in patients with knee OA was closely related to knee pressure points, and the number of pressure points and the degree of pressure reflected the degree of knee pain. The number of pressure points was significantly reduced after treatment, and the number of reductions was not closely related to the duration of treatment. The patellar friction test reflected the damage of the femoral patellofemoral joint, and a positive result indicated pain in this joint. The rate of negative patellar friction test increased significantly after 2 weeks of treatment, and the therapy was effective in relieving the pain of the femoral patellofemoral joint. From the clinical observation, it was found that the painful movement of the knee joint could be relieved due to the stabbing and stripping maneuver around the patella. The above three indicators indicate from different aspects that the small needle knife has a significant effect on the relief of knee pain in knee OA. The effect of small acupuncture on swelling: knee swelling in patients with knee OA is due to inflammation of the synovial membrane and other soft tissues, and acute inflammation of the synovial membrane is dominated by inflammatory exudation and chronic by hyperplasia, both of which are manifested as knee swelling. We used three indicators to observe knee swelling: knee circumference, effusion induction test, and floating patella test. Small acupuncture has a certain therapeutic effect on knee swelling in patients with knee OA, and the knee swelling tended to gradually subside and decrease throughout the treatment. 4, Summary Under the guidance of the principles of Chinese medicine diagnosis and treatment, combined with anatomical knowledge, the correct use of small needle knife therapy can significantly improve the pain indicators and swelling signs of knee OA, effectively reduce patient pain, improve the function of the knee joint, and delay the pathological process of knee OA. Although small acupuncture therapy is not the only option for patients with knee OA, its role in providing some pain and swelling relief should not be overlooked.