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In recent decades, the role of microRNAs (miRNAs) in human diseases has been widely studied. This research is designed to explore the effect of miR-218-5p on knee osteoarthritis (KOA) progression in a rat model with the involvement of sclerostin (SOST). The KOA rat models were constructed by Hulth method, and then were classified into the KOA, miR-218-5p inhibitor, inhibitor negative control (NC), overexpressed (OE)-SOST, OE-NC, miR-218-5p inhibitor + si-SOST, or miR-218-5p inhibitor + si-NC group. The pathological changes of rats' synov