〔Abstract〕 Objective To investigate the effect of fibular osteotomy combined with arthroscopic microfracture technique on knee function in patients with knee osteoarthritis. Methods A total of 60 patients with knee osteoarthritis admitted to Henan Asia Pacific Orthopaedic Hospital from December 2018 to May 2020 were selected and divided into control group and observation group according to random number table method, with 30 cases in each group. The control group was treated with arthroscopic fracture technique, and the observation group was treated with fibula osteotomy on the basis of the control group. The joint symptoms, joint fluid inflammation level and related knee Angle of the two groups were observed. Results After six months treatment, the joint swelling score, visual analogue scale (VAS) score, the levels of tumor necrosis factor–α (TNF–α), and interleukin-6 (IL-6) were reduced to some extent, the degree of joint motion was increased to different extent, and after 6 months treatment of the joint swelling score, VAS score, the levels of TNF–α, and IL-6 were lower than those in the control group, the degree of joint motion was significantly higher than that of the control group (P < 0.05). After 6 months of treatment, there were no significant differences in femoral tibia angle (FT), included angle of femoral ankle and femoral shaft connection (FA) and tibial joint space angle (JS) in the control group compared with before treatment (P > 0.05). After 6 months of treatment, FT, FA and JS in the observation group were lower than before treatment, and FT, FA and JS in the observation group were lower than those in the control group, the differences were statistically significant (P < 0.05). Conclusion Fibular osteotomy combined with arthroscopic microfracture technique in the treatment of knee osteoarthritis can significantly reduce joint symptoms, down-regulate the level of synovial fluid inflammation, and improve the related angle of the knee joint.