This article presents a clinical update on the treatment of osteoarthritis. The first avenue of treatment has been with the patients themselves. If the changes in lifestyle do not work then surgical intervention can be added. Joint replacement of the knee or hip is appropriate only for patients with advanced diseases or substantial symptoms that do not respond to other treatments. Arthroscopic surgery of the knee is common in the middle-aged but is of questionable benefit. Intra-articular injections offer short term relief but are costly. The risk and benefits of other treatments are explored.