摘要Knee osteoarthritis(KOA)is a prevalent chronic degenerative joint disorder characterized by an imbalance between articular cartilage degradation and synthesis,a central mechanism in KOA pathogenesis.Given the absence of disease-modifying therapies,there is a critical need to elucidate the underlying pathological processes,establish reliable biomarkers for early de-tection and prognosis,and identify safer,more effective therapeutic agents.In recent years,natural products have attracted considerable interest due to their low toxicity,cost-effective-ness,and distinct biological activities,demonstrating significant potential in KOA manage-ment.These compounds can impede KOA progression through multiple mechanisms,includ-ing promoting cartilage matrix synthesis,mitigating inflammation,reducing oxidative stress,suppressing chondrocyte apoptosis,and modulating autophagy,thereby supporting their translational application.This review summarizes biomarkers relevant to early diagnosis and phenotypic stratification in KOA,with a focus on elucidating the pharmacological actions and molecular mechanisms of natural products,such as flavonoids,alkaloids,saponins,terpenes,and traditional Chinese medicine(TCM)formulas,in KOA intervention,aiming to provide evidence-based strategies for improved disease management.