Randomized clinical trial in patients with knee osteoarthritis. Sixty patients will be evaluated, divided in three groups (20 in each). One group A will be treated by dry needling in the vast internal, other group B will be treated with a standardized treatment protocol (electrotherapy and manual therapy), and group C will be treated with hialuronic acid. The investigators want to observe which technique is the most effective in osteoarthritis.

Inclusion Criteria:

• Patients with knee pain and diagnosed of osteoarthritis knee and confirm RNM
• More 18 years.
• Less 55 years

Exclusion Criteria:

• More 55 years.
• Less 18 years.
• mental dysfunction
• those who have any type of complication that can cause myofascial or neuropathic pain in the lower limb, such as lumbo-sacral radiculopathy, neuropraxia, neurothymesis, axonotmesis, or meralgia paraesthetica; who have any condition generally considered to be a factor in perpetuating TrPs, such as fibromyalgia, hypothyroidism, or iron deficiency; and patients who may have a fear of needles (belonephobia) will be excluded.

Patients with lower limb dysmetries of 0.50 cm or more were also excluded from this study.