Abstract： Objective： To observe the effect of intraoperative application of Pingle GUO's massage tendonregulation manipulation on early rehabilitation after knee arthroplasty. Methods：Clinical data of 60 patients with knee osteoarthritis who underwent knee arthroplasty in the Department of Osteoarthropathy of Shenzhen Pingle Orthopedic Hospital from January 2024 to January 2025 were analyzed. According to various treatment methods，they were divided into the observation group and the control group，with 30 cases in each group. In the observation group，after prosthesis implantation and sterile dressing application， the tourniquet was released， and Pingle GUO's massage tendon- regulation manipulation was applied to the affected lower leg for 10 minutes. Subsequently，the bandage was removed， and an electrocautery knife was used for hemostasis until no obvious bleeding points remained. In the control group， after prosthesis implantation and sterile dressing application， the tourniquet was released， and the affected limb was placed flat and left undisturbed for 10 minutes. Subsequently，the bandage was removed，and an electrocautery knife was used for hemostasis until no obvious bleeding points remained. One week after surgery， clinical efficacy was evaluated by measuring swelling of the affected limb， D-dimer levels， knee joint range of motion （ROM）， Visual Analogue Scale （VAS） score of pain，and the incidence of deep vein thrombosis （DVT） in both groups. Results：On postoperative days one and four， the thigh circumference of the affected limb in both groups increased significantly compared with those before the operation （P＜0.05），but the observation group's thigh circumference was significantly smaller than that of the control group at the same time points （P＜0.05）. On postoperative day seven， the thigh circumference in two groups were close to the preoperative level （P＞0.05），and was significantly smaller than that in the control group （P＜0.05）. On postoperative day one，the VAS pain score in the observation group was close to the preoperative level （P＞0.05） and was lower than that in the control group （P＜0.05）； the VAS score in the control group was higher than that before the operation （P＜0.05）. On postoperative days four and seven，the VAS scores in both groups decreased compared with those before the operation （P＜0.05），and the observation group had lower VAS scores than the control group at the same time points （P ＜ 0.05）. On postoperative days one， four， and seven， D-dimer levels in both groups increased compared with those before the operation （P＜0.05）， but the observation group had significantly lower D-dimer levels than the control group at the same time points （P＜0.05）. On postoperative days one，four，and seven，the knee joint ROM of the affected limb in both groups increased compared with that before the operation（ P＜0.05），and the observation group had greater knee joint ROM than the control group at the same time points （P＜0.05）. On postoperative day seven，no lower extremity DVT was found in the observation group，while the incidence of DVT in the control group was 16.67% （5/30）， the difference between the two groups was statistically significant （P＜0.05）. During treatment， no complications such as surgical site infection， long-term disunion of the surgical site， or neurovascular injury occurred in either group. Conclusion： The intraoperative application of Pingle GUO's massage tendon-regulation manipulation in knee arthroplasty can alleviate swelling of the affected limb，improve blood circulation，reduce the risk of thrombosis，relieve pain，and enhance the range of motion of the affected knee joint in the early postoperative period，thereby facilitating early postoperative rehabilitation.