Objective:To observe the clinical efficacy of intra-articular injection of chitosan combined with manipulation in the treatment of degenerative knee osteoarthritis. Methods120 patients were randomly divided into the control group and treatment group,60 cases in each group. The control group was only treated with chitosan by intra-articular injection,the treatment group was treated with manipulation plus chitosan by intra-articular injection,with a course of 5 weeks. The clinical efficacy and the changes of WOMAC scores were observed.  Results:The total effective rates were 95.0% in the treatment group and 88.3% in the control group,and the clinical efficacy of the treatment group was better than that of the control group(P<0.05). After treatment,the scores of knee pain,stiffness and joint function were significantly decreased in both groups(P<0.05),and the reductions of stiffness and joint function scores in the treatment group were greater than those in the control group(P<0.05).  Conclusion:The intra-articular injection of chitosan combined with manipulation shows good clinical efficacy in the treatment of degenerative knee osteoarthritis,which is safe and reliable. Compared with intra-articular injection alone,it can better improve the knee stiffness and joint function of patients.