Objective To investigate the relationship of cartilage expression profiles of adiponectin from knee osteoarthritis (OA) with the severity of cartilage injury. Methods Clinical data of 18 OA patients undergoing total knee arthroplasty in our department from June 2016 to December 2016 were collected in this study. Their cartilages tissues from the medial and lateral tibial plateaus were harvested to detect the mRNA expression level of adiponectin by real-time quantitative PCR. Results The expression level of adi-ponectin was significantly lower in the cartilage tissues from the medial tibial plateau than those from lateral tibial plateau [ΔCt value (1.93±0.85) vs (1.42±0.55) cycles, P<0.05]. With the expression level of adiponectin in Outerbridge grade Ⅳ cartilage from the medial tibial plateau as a dependent variable (ΔCt value), and body mass index(BMI), hospital for special surgery(HSS) score and varus angle as independent variables, their Beta values were -0.491, -0.459 and -0.54, respectively. And the Beta values were -0.095, 0.112 and -0.067, respectively when the ΔCt value in non-grade Ⅳ cartilage from the lateral tibial plateau was regarded as a dependent variable, and the above 3 indicators as independent variables. ΔCt of adiponectin from the medial tibial plateau was negatively correlated with 3 indicators.Conclusion The cartilage expression level of adiponectin is associated with the severity of cartilage injury in knee OA. The expression level is milder in the grade Ⅳ cartilage from the medial tibial plateau than in non-grade Ⅳ cartilage from the lateral tibial plateau.