[Abstract] Objective To evaluate the efficacy and safety of extracorporeal shock wave combined with arthroscopic surgery for the treatment of knee osteoarthritis. Methods 360 patients were randomly divided into extracorporeal shock wave combined with arthroscopic surgery group (group A), simple extracorporeal shock wave treatment group (group B) and simple arthroscopic surgery group (group C), there were 120 cases in each group. The VAS pain 、Lysholm function and Range of motion scores were examined before and after 2, 6, 12, and 24 weeks after treatment, and the contents of NO and SOD in synovial fluid were detected and compared. Results Compared with before treatment, the VAS pain scores were decreased in the three groups after 2, 6, 12, and 24 weeks treatment, and the Lysholm functional scores were improved,and the Range of motion scores were improved. The difference between the combined treatment group and the other two groups was statistically significant. The contents of NO, IL-1β,TNF-α, MMP-3 and SOD in the 2, 6, 12, and 24 weeks after treatment were significantly different from those before treatment. There were statistical differences between the combined group and the other two groups. Conclusion This study preliminarily confirmed the auxiliary effect of extracorporeal shock wave on arthroscopic surgery that the extracorporeal shock wave combined with arthroscopic surgery for knee osteoarthritis is a safe and effective clinical minimally invasive treatment method, which is worthy of popularization and application.