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中华关节外科杂志(电子版) ›› 2026, Vol. 20 ›› Issue (01) : 1 -14. doi: 10.3877/cma.j.issn.1674-134X.2026.01.001

专家共识

中国膝骨关节炎关节腔注射治疗专家共识（2026版）
中华医学会骨科学分会关节外科学组, 王坤正1,†(), 史占军2,†(), 曲铁兵3,†()   
  1. 1710004　西安交通大学第二附属医院
    2510515　广州，南方医科大学南方医院
    3100020　北京，首都医科大学附属北京朝阳医院
  • 收稿日期:2026-01-09 出版日期:2026-02-01
  • 通信作者: 王坤正, 史占军, 曲铁兵
  • 基金资助:
    国家自然科学基金青年项目(82302733)

Chinese expert consensus on intra-articular injection therapy for knee osteoarthritis in China (2026 edition)

Joint Surgery Group of the Orthopaedic Society of the Chinese Medical Association, Kunzheng Wang1,†(), Zhanjun Shi2,†(), Tiebing Qu3,†()   

  1. 1The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004, China
    2Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
    3Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
  • Received:2026-01-09 Published:2026-02-01
  • Corresponding author: Kunzheng Wang, Zhanjun Shi, Tiebing Qu
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中华医学会骨科学分会关节外科学组, 王坤正, 史占军, 曲铁兵. 中国膝骨关节炎关节腔注射治疗专家共识（2026版）[J/OL]. 中华关节外科杂志(电子版), 2026, 20(01): 1-14.

Joint Surgery Group of the Orthopaedic Society of the Chinese Medical Association, Kunzheng Wang, Zhanjun Shi, Tiebing Qu. Chinese expert consensus on intra-articular injection therapy for knee osteoarthritis in China (2026 edition)[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2026, 20(01): 1-14.

随着我国人口老龄化趋势的发展，膝骨关节炎（KOA）逐渐成为我国中老年人群致残、致畸的主要病因之一。膝关节腔注射治疗作为KOA分级治疗原则中的重要手段之一，对缓解KOA症状，推迟手术治疗时机等具有关键作用。然而，随着膝关节腔注射治疗技术和认知的发展，目前国内外对KOA关节腔内注射治疗的临床应用仍存在诸多争议。如何给予KOA患者精准、规范、有效的膝关节腔内注射治疗是临床亟待解决的问题。鉴于此，本共识专家组参考国际规范和国内外最新研究证据、指南及共识，并结合多领域专家意见，制订了本共识。本共识旨在为临床医生安全规范地使用膝关节腔内注射药物提供指导，以提高KOA分级治疗中膝关节腔内注射治疗的诊治水平。本共识共提出了10条推荐意见，涵盖了KOA膝关节腔注射治疗的适用人群、治疗目标、注射药物选择、用药策略以及对新型关节腔内注射制剂的探索应用等方面。共识强调，KOA患者的膝关节腔内注射治疗需在充分的个体评估基础上，根据实际临床情况规范实施。

关键词: 骨关节炎，膝, 注射，关节内, 共识

With the aging population trend, knee osteoarthritis (KOA) has gradually become one of the leading causes of disability and deformity among middle-aged and elderly people in China. As a key component of the stepped care approach for KOA, intra-articular injection (IA) plays a critical role in alleviating mild KOA and delaying the need for surgical intervention. However, despite advancements in intra-articular injection techniques and understanding, there remain numerous controversies regarding its clinical application both domestically and internationally. How to provide precise, standardized, and effective intra-articular injection therapy for KOA patients is an urgent clinical issue to address. In light of this, the expert panel of this consensus referred to international standards, the latest research evidence, guidelines, and consensus documents from China and abroad, integrating opinions from multidisciplinary experts to develop this consensus. The consensus aims to guide clinicians in the safe and standardized use of intra-articular injections, thereby improving the diagnosis and treatment level of intra-articular injection therapy within KOA stepped care. The consensus puts forward 10 recommendations, covering aspects such as the target population for KOA intra-articular injection therapy, treatment goals, selection of injectable drugs, medication strategies, and the exploration and application of new intra-articular injection biological agents. The consensus emphasizes that intra-articular injection therapy for KOA patients should be based on comprehensive individual assessment and implemented properly according to actual clinical circumstances.

Key words: Osteoarthritis, knee, Injections, intra-articular, Consensus
表1 推荐证据等级和推荐强度说明
级别 强推荐（1） 弱推荐（2）
高质量（A） 大多数情况下，推荐意见适用于大多数患者；非常有把握估计值接近真实值 最佳决策会因环境、患者和社会价值而不同；非常有把握估计值接近真实值
中等质量（B） 大多数情况下，推荐意见适用于大多数患者；对估计值有中等把握：估计值有可能接近真实值，但也有可能差别很大 在某些情况下，替代方案对某些患者有可能更好；对估计值有中等把握：估计值有可能接近真实值，但也有可能差别很大
低质量（C） 当有更高质量证据时，推荐意见有可能改变；对估计值的把握有限：估计值可能与真实值有很大差别 其他的替代方案同样合理；对估计值的把握有限：估计值可能与真实值有很大差别
极低质量（D） 当有更高质量证据时，推荐意见有可能改变；对估计值几乎没有把握：估计值与真实值极可能有很大差别。 其他的替代措施同样合理；对估计值几乎没有把握：估计值与真实值极可能有很大差别
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