Knee osteoarthritis (KOA) is a prevalent chronic degenerative articular disorder predominantly affecting the middle-aged and elderly population, clinically characterized by articular pain, swelling, and motor dysfunction, which exerts a severe negative impact on patients' physical health and quality of life. At present, conventional pharmaceutical therapies for KOA are associated with notable adverse effects, while surgical interventions entail inherent high risks and potential postoperative complications. Based on the anatomical features of the knee joint and integrated with the theoretical connotations of traditional Chinese acupuncture and moxibustion, Professor Ni Guangxia has developed a targeted acupuncture therapy for KOA: taking Neixiyan (EX-LE4) and Waixiyan (EX-LE5) as the core acupoints, the therapy adopts long needles for deep puncture combined with multi-directional mutual penetration manipulation at the affected area. This acupuncture approach yields rapid therapeutic effects, can remarkably alleviate articular pain, effectively restore the motor function of the knee joint, and demonstrate durable curative efficacy in clinical practice. This paper elaborates on the standardized operational procedures and typical proven clinical cases of this therapy, and further explores its underlying theoretical basis and therapeutic mechanism, aiming to provide novel clinical insights and practical therapeutic strategies for the clinical diagnosis and treatment of knee osteoarthritis.