To evaluate the indication and clinical effect with arthroscopy and four-channel cleaning technique to treat the joint adhesion after total knee arthroplasty. Methods From March 2014 to March 2017, 13 patients of the joint adhesion after total knee arthroplasty were treated with arthroscopy and four-channel cleaning technique. Among them, 4 males and 9 females; The average age is 66.7 years (58?~?73 years). Lysholm score was used to evaluate the preoperative and postoperative function of knee joint and to record the flexion and extension of knee joint before and after surgery. Results All the patients were follow-up for 6 to 24 months, with an average of 13.6 months after the operation. The mean knee flexion was 73.7°(45°?~?90°) before the surgery and was 115.7°(97°?~?127°) at the time of 6 months follow-up. Lysholm scored an average of 54 points (31?~?69 points) before surgery, and the average score was 66.8 (51?~?83 points) for 6 months after surgery. Conclusion Arthroscopy and “four-channel cleaning” technique is a safe and effective method to treat joint adhesion after total knee arthroplasty, and it has significant effect on the improvement of knee joint function.