Osteoarthritis (OA) is a highly prevalent degenerative joint disease representing a substantial burden for affected individuals, families, and the society. Thus, standardized diagnosis and treatment of OA are of great significance to clinical work and social development. This guideline update was initiated by the Joint Surgery Branch of the Chinese Orthopaedic Association, the Subspecialty Group of Osteoarthritis, Chinese Association of Orthopaedic Surgeons, the National Clinical Research Center for Geriatric Disorders (Xiangya Hospital) and the editorial department of the Chinese Journal of Orthopaedics. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach and the Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist were adopted. Finally, 30 evidence-based recommendations were formulated based on 15 most concerned clinical problems among orthopaedic surgeons in China. This guideline is intended to improve the scientific nature of OA diagnosis and treatment and ultimately improve the quality of patient-centered medical services.