Abstract: OBJECTIVE To observe the clinical effectiveness of the combination of Tuina and functional exercise in the treatment of knee osteoarthritis (KOA). METHODS 180 KOA patients admitted in our hospital from Jan. 2016 to Dec. 2106 were selected and randomly divided into the observation group A， B and the control group by random number， 60 cases in each group. The control group was intervened by normalized functional exercise， the observation A group was intervened by Tuina with Chinese medicines characteristics on the basis of the control group， and the observation group B was treated with glucosamine sulfate capsules on the basis of the control group. Scores of knee-joint swelling， tenderness， joint activity and Lysholm knee function were evaluated before and after treatment. Knee joint fluid was extracted from patients and Matrix metalloproteinase-3 (MMP3)， tissue inhibitor of metalloproteinase 1 (TIMP1) and tumor necrosis factor-α (TNF-α) were tested before and after treatment. The clinical efficacy after treatment and safety during treatment were evaluated in two groups. RESULTS Scores of knee-joint swelling， tenderness and joint activity in three groups significantly decreased after treatment (P<0.05)， and Lysholm knee function scores increased significantly (P<0.05)， but scores of knee-joint swelling， tenderness and joint activity in observation groups A and B decreased more significantly (P<0.05)， and Lysholm knee function scores increased more significantly (P<0.05). Levels of MMP3， TIMP1 and TNF-α in three groups decreased significantly after treatment(P<0.05)， but observation groups A and B decreased more significantly(P<0.05). Total effective rates in observation groups A and B were 95.00% and 1.67%， respectively， which were significantly higher than that in the control group (75.00%)， the differences were statistically significant (2=9.412、8.757， P<0.01). There were no obvious adverse reactions in three groups， and the safety was grade I. CONCLUSION The combination of Tuina and functional exercise has significant clinical effectiveness and high safety in the treatment of KOA， which is worthy of clinical promotion.