To explore the clinical effect of acupotomology combined with Mulligan manipulation in the treatment of intermediate stage knee osteoarthritis(KOA).Methods:A total of 120 patients with intermediate stage degenerative KOA treated at the Longhua Hospital Affiliated to Shanghai University of traditional Chinese Medicine and its Jinshan Branch from September 2019 to September 2020 were selected for the study.These patients were randomly divided into acupotomy group(n=40)，manipulation group(n=40)，and combined group(n=40).The acupotomy group was treated with acupotomy alone，the manipulation group was treated with Mulligan manipulation，and the combined group received a combination of acupotomology and Mulligan manipulation.The changes in osteoarthritis indices，pain visual analog scale scores，results of the sit-to-stand test at 5 repetitions，and clinical efficacy of the three groups were observed before treatment，after treatment and at a 24-week follow-up.Results:Compared with the manipulation group and acupotomy group，the combined group showed statistically significant differences in the pain visual analogue score，osteoarthritis index scores and the results of the sit-to-stand test at 5 repetitions after treatment and at a 24-week follow-up(P<0.01).The overall clinical efficacy rate in the combined group was 97.50%，which was significantly higher than that in the acupotomy group(92.10%) and that in the manipulation group(75.00%)，with statistically significant differences(P<0.05).Conclusion:Acupotomology combined with Mulligan manipulation in the treatment of intermediate stage KOA exhibits significant efficacy in improving the symptoms such as joint pain，stiffness，and impaired mobility，both in the short-term and long-term.This approach is worthy of clinical promotion and application.