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A 46-year-old male patient suffered from bilateral knee joint pain and swelling for 3 years. He also complained of stiffness of the knee joint along with the crackling sound during movements. Six months back the patient took conventional treatments like NSAIDs and physiotherapy. But the symptoms persisted and for further management, he consulted Dr Dudhmal. Based on physical examination and radiological findings the biomedical diagnosis was made as Osteoarthritis of bilateral knee joint - KL grade- 2. The ayurvedic diagnosis was Janusandhigata vata. The line of treatment adopted was Agnikarma with electrocautery. This was done once a week for 1 month. Pre- and post-treatment assessment was done with VAS, stiffness, and the range of movements. After 4 sittings of Agni karma, the VAS recorded as 7 before treatment became 2 after treatment. There is no swelling and stiffness and the range of movement improved. The patient is in remission.