Osteoarthritis of the knee is a commonly treated orthopaedic condition that can be quite disabling, often leading to significantly reduced activity levels. Non-operative treatment is the first line of management with non-steroidal anti-inflammatory agents, intra-articular injections, knee braces, weight loss and activity modification. While there has been a growing interest in topical agents, stem cell/platelet-rich-plasma injections and shoe modifications, the overall efficacy of such modalities in relationship to the relative cost remains a question. Surgical options typically include total knee arthroplasty, unicompartmental knee arthroplasty and patellofemoral joint arthroplasty, depending on the extent and location of the degenerative joint disease. Arthroplasty options provide excellent long-term outcomes in appropriately indicated patients. Modern total knee arthroplasty components are well-designed and if put in appropriately in a patient that is willing to do their physical therapy, excellent results are commonly found. Unicompartmental knee arthroplasty has also experienced a resurgence with the push for less invasive surgery and more rapid rehabilitation. Successful results can be achieved with meticulous surgical techique and appropriately indicated patients. The following is a thorough review of the modern options for the management of knee degenerative joint disease, focusing on the latest arthroplasty procedures.