Abstract: Knee osteoarthritis(KOA) is a common disease in the elderly. Pain， the most common symptom of KOA， is seen in more than 65% of the patients as main manifestation in clinic. At present， there is no clear pathogenesis and specific treatment of KOA. Conservative treatment， mainly including the control of inflammation and delay of cartilage degeneration， is for controlling pain and other clinical symptoms. KOA belongs to "Bone Bi" and "Bi syndrome" of traditional Chinese medicine. By reviewing the literature on the treatment experience of KOA in orthopedics and traumatology of TCM and combining the experience of department of orthopedics and traumatology in our hospital， diagnostic and therapeutic ideology centered by the control of intractable pain of KOA is put forward with the therapeutic system guided by the concept of truncating and reversing and the combination of cold and heat.