Knee osteoarthritis (KOA) is a common degenerative joint disorder that substantially affects the quality of life of a large proportion of the aging population worldwide. Since the publication of ＜the 2018 Expert consensus on the stepped treatment of knee osteoarthritis＞, the stepped treatment of knee osteoarthritis has been widely implemented and clinically validated, demonstrating significant benefits in symptom relief and functional improvement. As a core therapeutic concept, the stepped treatment approach emphasizes the selection of individualized interventions according to disease stage and symptom severity. Through sequential and progressive treatment strategies, it aims to provide effective management for patients with KOA at different stages, alleviate pain, improve joint function, and enhance health-related quality of life. This updated expert consensus retains the fundamental principles of stepped treatment while incorporating recent advances in therapeutic techniques and scientific evidence. Emerging biological therapies have demonstrated potential in the management of early-to moderate-stage KOA, providing additional treatment options within the stepped care framework. Furthermore, the integration of digital-assisted technologies has enabled more personalized and precise treatment strategies, particularly in surgical management, by improving procedural accuracy and potentially optimizing postoperative outcomes. This revision focused on updating novel concepts, emerging approaches, and advances in KOA stepped treatment. The objective of this consensus is to provide evidence-based, standardized, and practical recommendations for healthcare providers, medical institutions, and clinicians at different levels of care, thereby facilitating the effective implementation of stepped treatment t strategies for KOA.