Abstract： Objective： To observe the curative effect of Wenshen Xuanbi Decoction combined with western medicine on knee osteoarthritis complicated with osteoporosis and its effect on bone metabolism indexes. Method： A total of 102 cases of patients with knee osteoarthritis complicated with osteoporosis were selected and divided into the Chinese medicine group (59 cases) and the routine group (43 cases) according to different medication methods. Both groups were given routine western medicine treatment， and the Chinese medicine group was additionally treated with Wenshen Xuanbi Decoction. The changes in traditional Chinese medicine syndrome scores，Visual Analogue Scale (VAS) for pain，Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores， bone metabolism markers [tartrate- resistant acid phosphatase (TRACP) -5b， β -C-terminal telopeptide of type I collagen (β -CTX)， Nterminal propeptide of type I procollagen (PINP)， osteocalcin (OC)]， and inflammatory factors [matrix metalloproteinase-3 (MMP-3)，tumor necrosis factor- α (TNF- α)，interleukin-1 (IL-1)] levels before and after treatment were compared between the two groups，and the clinical effects were compared between the two groups. Results：After treatment，the VAS scores，traditional Chinese medicine syndrome scores， and WOMAC scores in the two groups were decreased when compared with those before treatment (P＜ 0.05)， and the above three scores in the Chinese medicine group were lower than those in the routine group (P＜0.05). After treatment， the total effective rate of clinical effect was 94.92% in the Chinese medicine group and 76.74% in the routine group， the difference being significant (P＜0.05). After treatment，the levels of PINP and OC in the two groups were increased when compared with those before treatment (P＜0.05)，and the levels of β-CTX and TRACP-5 were decreased when compared with those before treatment (P＜0.05)； the levels of PINP and OC in the Chinese medicine group were higher than those in the routine group (P＜0.05)，and the levels of β-CTX and TRACP-5 were lower than those in the routine group (P＜0.05). After treatment，the levels of MMP-3，IL-1，and TNF-α in the two groups were reduced when compared with those before treatment (P＜0.05)，and the above three levels in the Chinese medicine group were lower than those in the routine group (P＜0.05). Conclusion： Wenshen Xuanbi Decoction combined with western medicine can effectively relieve the clinical symptoms and bone pain of patients with knee osteoarthritis complicated with osteoporosis， regulate bone metabolism levels and reduce inflammatory factors，with a definite clinical effect.