Osteoarthritis (OA) is a major chronic disease of the joints, affecting mostly the articular cartilage but also all the surrounding tissues including the subchondral bone, synovium, meniscus, tendons, and ligaments. Despite the availability in the clinic of a variety of therapeutic approaches, there is crucial need for improved treatment to protect and regenerate the cartilage with full integrity and function. In this regard, combining gene, cell, and tissue engineering-based procedures is an attractive concept for novel, effective therapy against AO, a slow, progressive, and irreversible disease. Here, we provide an overview of the treatment available for management of the progression of the OA phenotype and discuss current progress and remaining challenges for potential future treatment of patients.