The current definition of osteoarthritis is a group of overlapping distinct diseases, which may have different etiologies but with similar biologic, morphologic, and clinical outcomes. The disease processes not only affect the articular cartilage, but involve the entire joint, including the subchondral bone, ligaments, capsule, synovial membrane, and Periarticular muscles. Ultimately, the articular cartilage degenerates with fibrillation, fissures, ulceration, full thickness loss of the joint surface, sclerosis and eburnation of subchondral bone, osteophytes, and subchondral cysts. The Non arthroplastic treatment of OA can be divided into non pharmacologic interventions, pharmacologic interventions, surgical options, and under research is tissue engineering and gene therapy. Non pharmacologic Management relays upon Patient education, weight loss, Exercise (low-impact aerobic exercise program; walking, biking, or swimming or other aquatic exercise, Quadriceps-strengthening exercises), Heat modalities, modified activities of daily living, Knee braces and Orthotics. Pharmacological Management includes Topical agents, systemic agents, Diacerein, Nutraceuticals (dietary supplements), disease modifying therapies and intra articular agents. Surgical treatment relays upon repair of articular cartilage by various methods which can be categorized in to four basic techniques: stimulation of cartilage regeneration, transfer of autogenus tissue and cells, transfer of allograft tissue and alteration of load. Arthroscopic treatment is considered only in patients who have mild to moderate osteoarthritis with symptoms suggestive of mechanical derangement