Knee osteoarthritis (OA) is a primary cause of joint dysfunction. Knee osteotomy has garnered significant attention due to its potential to delay the progression of knee OA and enhance joint function. As a pivotal biomechanical factor in the onset and progression of OA, the accurate correction of abnormal knee alignment is the central objective of knee osteotomy. This article systematically reviews the biomechanical research progress related to knee osteotomy, with a focus on the precision and personalized correction of force line. The development of new classification system and measurement technology of force line is summarized, the biomechanical mechanism of knee OA induced by abnormal mechanical load is analyzed, and the goal of force line and clinical application progress of knee osteotomy is discusses, so as to provide a new perspective and idea for the clinical treatment of knee OA with knee osteotomy.