Abstract: The physiology of chondrocyte is summarized in matrix synthesis and degradation. The imbalance between the two seems to be the trigger for osteoarthritis. The end products of matrix degradation result in inflammation that will cause the release of interleukine-1 (IL-1) and tumor necrosis factor α (TNF α) by synovial cells. Non steroidal anti inflammatory drugs (NSAID) by reducing the inflammation may interfere at this level and reduce the release of these cytokines. IL-1 and TNF α will stimulate chondrocytes resulting in the activation of inactive matrix metalloproteinases, activation of chondrocyte metalloproteinase synthesis, increase in synthesis and expression of IL-1 and TNF α receptors, synthesis and release of IL-1 and TNF α by chondrocyte itself, synthesis and release of nitric oxide via inducible nitric oxide synthase (iNOS), depression of chondrocyte anabolism, and apoptosis. Avocado/Soya unsaponifiables and doxycycline can inhibit metalloproteinase can inhibit metalloproteinases. Many products may inhibit NO synthesis or its release 6-B and among them anti-oxidant agents such as vitamin C and vitamin E, or anti-depressive agents amitriptyline and fluoxetine. The anabolism of chondrocyte (macromolecule synthesis) may be enhanced by different products such as Avocado/Soya unsaponifiables, chondroitin sulphate and glycosamine. Other factors may influence the physiology of cartilage: Aging, genetic impairment, overweight, work, stress, muscle weakness, trauma, diet, and menopause. Adequate exercises, weight control, better work conditions, adequate diet (vitamin C, D, and E), and estrogen replacement therapy may modify some of those factors. A therapeutic scheme taking in account the above factors may be proposed as: 1- Rest and NSAID for the acute inflammatory attack of osteoarthritis. 2- Use of structure modifying osteoarthritis drugs. Avocado/Soya unsaponifiables is to be used in a 6-month period (1 capsule of 300 mg per day). Glucosamine sulphate is to be used for several years (1500 mg daily). 3- Adequate diet for weight control and micronutrients supply. 4- Adequate exercises for improvement of muscle strength. 5­- Improvement of work conditions. 6- Hormone replacement therapy after menopause.