This review critically evaluates the advancements in multifunctional hydrogels, particularly focusing on their applications in osteoarthritis (OA) therapy. The shift from traditional natural materials to synthetic and composite hydrogels has led to superior mechanical properties and enhanced biodegradability. Novel applications such as injectable hydrogels, microneedle technology, and responsive hydrogels have revolutionized OA treatment through targeted and efficient therapeutic delivery. Protein-based and superlubricating hydrogels are highlighted for their potential to reduce joint friction and inflammation. The integration of bioactive compounds within hydrogels further enhances therapeutic efficacy. The review also discusses the future research trajectories and technological advancements in hydrogel-based OA therapies, emphasizing the potential of hydrogels to provide tailored, minimally invasive treatments.This review critically evaluates the advancements in multifunctional hydrogels, particularly focusing on their applications in osteoarthritis (OA) therapy. The shift from traditional natural materials to synthetic and composite hydrogels has led to superior mechanical properties and enhanced biodegradability. Novel applications such as injectable hydrogels, microneedle technology, and responsive hydrogels have revolutionized OA treatment through targeted and efficient therapeutic delivery. Protein-based and superlubricating hydrogels are highlighted for their potential to reduce joint friction and inflammation. The integration of bioactive compounds within hydrogels further enhances therapeutic efficacy. The review also discusses the future research trajectories and technological advancements in hydrogel-based OA therapies, emphasizing the potential of hydrogels to provide tailored, minimally invasive treatments.