Recently, our joint surgery department and endocrinology department jointly handled a case of refractory knee gout stone gout patient. The patient, Huang Mourong, 36 years old, had a history of gout for 3 years and was treated with various drugs orally for a long time. The blood uric acid was 357umol/L, rheumatic triad and routine blood biochemistry were normal. The patient’s right knee symptoms improved significantly after the operation, and the pain at night was relieved. As we all know, gout cannot be cured but only controlled. It is a metabolic disease caused by abnormal purine metabolism, which mainly manifests clinically as hyperuricemia and urate crystals deposited in joints, peri-articular tissues and subcutaneous tissues, with acute redness, swelling and severe pain, gradually producing bone and joint destruction, deformity, joint ankylosis and functional impairment. Refractory gouty stone gout is caused by recurrent attacks of acute gouty arthritis over several years and is mostly characterized by chronic, multiple, destructive arthritis with gouty stone formation. These patients mostly present with low age, recurrent gout attacks, and severe disease. Some patients do not have significantly elevated blood uric acid values, which are ineffective with existing medications and difficult to treat, and a few patients with gout stones often need to be treated with minimally invasive surgical procedures to remove the gout stones. The advantages of arthroscopic surgery are: it provides a good intra-articular view directly, accurately understands the lesions of various structures in the joint, and helps to improve the treatment plan; and it can directly remove a large number of crystals and gout stones, relieve the mechanical symptoms caused by free gout stones, and restore the normal metabolic process of joint cartilage. Of course arthroscopic surgery is only a local treatment for gouty arthritis; it can reduce the damage within the joint, but it is not a substitute for treatment such as acid removal, acid suppressant drugs, and diet control. Arthroscopy combined with a systematic and regular acid-removal program has a positive effect on refractory gouty stone gout.