Objective Observation of the effect of acupuncture on the surface electromyographic characteristics and muscle properties of lower limb muscle groups after high tibial osteotomy(HTO). Methods 80 patients who received unilateral HTO were randomly divided into a treatment group and a control group. The control group received routine postoperative rehabilitation, while the treatment group received acupuncture treatment on the fourth day after surgery, with 7 days as one course of treatment. Two consecutive courses of treatment were conducted to compare the electromyographic signals (integrated electromyographic value, median frequency) and muscle characteristics (oscillation frequency, logarithmic attenuation of amplitude, dynamic hardness) of each tested muscle before and after treatment in the two groups. Results Before treatment, there were no significant differences(P>0.05) in the integrated electromyographic values, median frequency, oscillation frequency, logarithmic attenuation of amplitude, and dynamic hardness between the two groups of tested muscles. After treatment, the integrated electromyographic values and median frequencies of each tested muscle in the treatment group were higher than those in the control group(P<0.05), while the oscillation frequency, logarithmic attenuation of amplitude, and dynamic hardness were lower than those in the control group (P<0.05). Conclusion Acupuncture can relieve the internal pressure of lower limb muscle groups, regulate muscle elasticity and hardness, improve muscle recruitment and exercise-induced fatigue, thereby exerting the effect of "soft muscle pain relief". This may be the effective pathway for acupuncture therapy to promote knee joint rehabilitation after HTO surgery.