Probably just to give additional equations. For example, with cubic splines, you have 4 coefficients per cubic and can require that the values of the function and first and second derivatives match at each knot. If you have n knots, including the two ends, you have two values requiring that both sides give the correct value there and two more equations requiring that the first and second derivatives match, for a total of 4 equations, at the n-2 interior knots but only one equation at the two ends for a total of 4(n-2)+ 2= 4n- 6 equations. But you also have n-1 intervals between those n points so a total of 4n- 4 coefficient to solve for. That is two fewer equations than coefficents!
What you can do is add the "not a knot" condition- you require that the polynomials in the first two intervals at each end be exactly the same. That is, that two "knots" are, in fact, not knots. That gives the value of the function at those two points as the two more equations you need.