Osteoarthritis of the knee is a common cause of knee pain in the elderly. Most patients with knee osteoarthritis have mild symptoms initially and can be treated for knee osteoarthritis with oral glucosamine sulfate, joint cavity injections of sodium glutamate, or the use of arthroscopy. If the disease worsens. Imaging changes of bone and cartilage destruction on the joint surface and moderate to severe persistent pain can be treated with knee replacement after six months of ineffective regular treatment. The main purpose of knee replacement is to relieve joint pain, correct joint deformity, restore joint function, and improve the patient’s quality of life. The procedure is well established, but it is well known that all joint replacement surgeries have a certain number of surgical complications that cannot be completely avoided. One of the more serious ones is infection around the prosthesis after artificial joint replacement. Although the infection rate has decreased from about 10% in the early years to 1% to 3% at present, the number of patients with complications has increased due to the increasing use of prosthetic arthroplasty. Therefore, knee replacement is generally the last resort for patients with osteoarthritis of the knee. In Ningjin County, Hebei Province, a doctor named Li Cunxiang invented a procedure around 2010 – “fibular osteotomy guided by the theory of uneven knee subsidence” – a new cost-saving and simple procedure that can partially replace knee replacement. This cost-saving and simple procedure is a partial replacement for knee replacement. Subsequently, this cost-saving, less invasive and effective procedure was widely promoted by the president of Hebei Provincial Hospital No. 3, Professor Zhang Yingze of Orthopaedics. More than 800 cases have been performed, and the knee pain relief rate has reached more than 98%. It is now being used clinically in more than 50 hospitals in 18 provinces across China, with remarkable results. Proximal fibular osteotomy is performed for patients with osteoarthritis of the knee joint. It is suitable for patients with pain, swelling and stiffness of the medial knee joint and mild O-leg. On November 24, 2014, the inaugural meeting of the National Academic Consortium for Uneven Knee Joint Settlement was held in Shijiazhuang. It was composed of top experts in orthopedic related fields from home and abroad. It was formally established that the occurrence of uneven settlement of the tibial plateau is an important factor in the occurrence and development of osteoarthritis of the medial compartment of the knee joint, and the theory of uneven settlement of the knee joint was proposed. And based on this theory, we adopted the proximal fibula osteotomy and achieved good results. It has enabled many patients who were not suitable or willing to have artificial joint replacement for various reasons to avoid the pain of knee joint pain. Moreover, it is less traumatic, less costly and has remarkable results. Based on the above theory and the obvious postoperative results. I performed a proximal fibular osteotomy on an elderly patient with osteoarthritis six months ago. The cost of the operation was $500, and the postoperative result was satisfactory. Recently, X-rays were reviewed. The preoperative joint dislocation and force lines were significantly restored, and the medial joint space was widened in the weight-bearing position. The patient’s knee movement and various pain scores were significantly improved compared to the preoperative period. The efficacy of this new surgical approach was confirmed. The procedure is less costly, less invasive, and effective in relieving tension in the lateral soft tissues of the knee after surgery, reducing pain and allowing the patient to walk with immediate weight bearing, making it an effective way to delay or even avoid knee replacement.