Arthritic deterioration of the knee joint is not an inevitable consequence of aging, and knowing the female-specific differences in prevalence and risk factors can contribute significantly to effective management. Because KOA has several modifiable risk factors, interventions should target primary prevention - i.e., weight loss, directed physical activity, and repetitive stress reduction. Challenges include an appreciation of the spectrum from asymptomatic to severe, and selection of the most effective management approaches. Treatment plans, including pharmacologic and nonpharmacologic measures, should be assessed in the context of evidenced-based medicine. Specific evidence-based interventions have the potential to modify the burden of disease, as well as reduce health care costs.