Abstract: [Objective] To study and analyze the clinical efficacy , safety and advantages of osteotomy of the upper fibula in the treatment of knee osteoarthritis (KOA) . [Method] A retrospective analysis of 60 KOA patients treated with osteotomy of the upper fibula in our hospital from February 2020 to February 2021 was performed , and the VAS score , HSS score , and KSS score of each period were compared . [Results] (1) The patient''s various surgical indicators : After all patients were treated with osteotomy of the upper fibula , they were routinely followed up for 1 to 14 months . The operation took 40 to 122 minutes , with an average of (81.00 ± 4.51 ) minutes . The length of hospital stays was 2-14 days , with an average of (8.00±1.83 ) days . Forty-three patients (71.67%) had no pain on the inner side of the knee joint after surgery , 15 cases (25.00%) had a significant decrease in pain on the inner side of the knee joint after surgery , and 1 case (1.67%) changed the position of pain after the operation , and 1 case (1.67%) ) . Postoperative pain was not relieved or worsened , 1 patient (1.67%) with restricted dorsal extension , 2 patients with breves tendon contraction (3.33%) , and 1 patient (1.67%) with common peroneal nerve injury . After the implementation of nutritional nerve therapy , 2 patients (3.33%) with intramuscular venous thrombosis in the affected limb showed improvement after anti coagulation therapy . (2) Analysis of VAS , Hss scores , and Kss scores of all patients : The Hss scores and Kss scores of all patients 2 months after the operation was higher than those before and 2 days after the operation , and the VAS scores were lower than those before and 2 days after the operation . The difference is significant . Statistically significant (p<0.05 ) . [Conclusion] The use of osteotomy of the upper fibula for KOA can improve the clinical efficacy , increase the safety of the treatment , and improve the pain value .