Osteoarthritis, the degenerative joint disease, most commonly affects the knee joint. Age and improper loading are the most important risk factors for osteoarthritis. Among the sports persons, runners, joggers, jumpers and the persons training by squatting exercises are the most prone to such changes. The biggest challenge in the management of osteoarthritic knees is to relieve pain and to retard the process of degeneration. Various causes have been attributed for the generation of pain. Microscopic as well as macroscopic degenerative debris arising from cartilage and synovium are the major factors. Pharmacological management as medicines, non-pharmacological non-surgical management in the form of physiotherapy and change of lifestyle and surgical management of different forms have been recommended depending upon the severity of osteoarthritis and choice of doctor. Knee lavage with steroid injection followed by regular physiotherapy is the most economical, durable and effective method in early cases of osteoarthritis knees to achieve pain relief and to improve the quality of life. Long-term results of 1500 cases of osteoarthritis knee treated by knee lavage using 4 litres of normal saline followed by 2 ml of DEPO-MEDROL injection and physiotherapy protocols are present. We had more than 80% excellent or good results using VAS scale for pain assessment, at the end of 2 years follow-up. The success rate is inversely related to the grade of osteoarthritis and the duration after the lavage. It is a very simple, economical and day care procedure and there should not be hesitation for repeat lavage after a few years if required.