Abstract: Objective To analyze the clinical efficacy of Tongjing Juanbi Capsules in the treatment of knee osteoarthritis (KOA) of the Liver-Kidney Deficiency Pattern and to investigate their effects on knee joint function and bone metabolism markers. Methods A total of 216 KOA patients with Liver-Kidney Deficiency Pattern admitted to Qinhuangdao Hospital of Traditional Chinese Medicine from January 2021 to June 2024 were enrolled. They were randomly divided into two groups, using a random number table. The control group (n=108) received glucosamine sulfate capsules and meloxicam, while the intervention group (n=108) received Tongjing Juanbi Capsules in addition to the same treatment. Clinical efficacy, traditional Chinese medicine (TCM) syndrome scores, pain intensity, knee joint function, bone metabolism markers, and adverse reactions were compared between the two groups. Results The total effective rate was significantly higher in the intervention group than in the control group (94.44% vs 85.19%, P＜0.05). At 1 and 3 months of treatment, the intervention group showed higher Lysholm knee scores and lower TCM syndrome scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and Lequesne index scores compared with both baseline values in the same group and those in the control group (P＜0.05). At 1, 2, and 3 months of treatment, the Visual Analogue Scale (VAS) score in the intervention group was lower than that before treatment in the same group and that in the control group (P＜0.05). At 1 and 3 months, the intervention group exhibited higher levels of osteoprotegerin (OPG) and osteocalcin (OC), and lower levels of C-terminal cross-linked telopeptide of type I collagen (CTX-I), compared with both baseline values in the same group and those in the control group (P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05). Conclusion Tongjing Juanbi Capsules can significantly increase the total clinical effective rate, improve knee joint function, alleviate pain, improve bone metabolism, and exhibit a favorable safety profile in the KOA patients with Liver-Kidney Deficiency Pattern.