Abstract： Objective： To observe the clinical effect of the combination use of foot-yangming meridian sinews manipulation and herbal-cake-separated moxibustion on knee osteoarthritis （KOA） and its effect on flexion and extension function of knee joints. Methods： A total of 100 KOA patients treated in the Affiliated Hospital of Henan Vocational College of tuina from May 2021 to May 2023 were selected as the study objects and divided into the observation group and the control group，with 50 cases in each group. The control group was treated with herbal-cakeseparated moxibustion， and the observation group was additionally treated with foot-yangming meridian sinews manipulation based on the treatment of the control group. The course of treatment was one month. The clinical effects， scores of main clinical symptoms and function of knee joints [Lysholm Knee Score Scale （Lysholm）] and levels of bone metabolism indexes [C-terminal telopeptides of type I collagen （CTX-I）， bone-γ-carboxyglutamic acid-containing protein （BGP）， osteoprotegerin （OPG）] were observed and compared between the two groups. Results： The total effective rate was 98.00%（49/50） in the observation group and 84.00 %（42/50） in the control group， the difference being significant （P＜0.05）. After treatment，the scores of knee joint pain and poor joint flexion and extension in the two groups were reduced when compared with those before treatment （P＜0.05）， and the above two scores in the observation group were lower than those in the control group （P＜0.05）. After treatment， the Lysholm scores of knee joint function in the two groups were elevated when compared with those before treatment （P＜0.05），and the Lysholm score in the observation group was higher than that in the control group （P＜0.05）. After treatment，the levels of serum CTX-I in the two groups were down-regulated when compared with those before treatment （P＜0.05），and the levels of BGP and OPG were increased when compared with those before treatment （P＜0.05）； the CTX-I level in the observation group was lower than that in the control group （P＜0.05），and the levels of BGP and OPG were higher than those in the control group （P＜0.05）. Conclusion： The combination use of foot-yangming meridian sinews manipulation and herbal-cake-separated moxibustion can enhance the clinical effect on KOA，effectively regulate the levels of bone metabolism indexes and improve the clinical symptoms and the flexion and extension function of knee joints.