It is clear that OA is a complex multifactorial disease process involving cartilage catabolism and anabolism. LIPUS may play a potential chondroprotective role in chondrocyte metabolism; enhance cell proliferation and matrix production. Aim of Study: Is to investigate the effect of Low Intensity Pulsed Ultrasound (LIPUS) therapy on cartilage repaire in patient with grade 2 or 3 osteoarthritis of the knee. Methods: Subjects were assigned in one pre and post study groupand receive 20 minutes of

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... PUS with power 60 mw/cm and frequency 100Hz over the medial tibiofemoral compartment of the knee of both lower limbs and that was 3 times per week for successive three months. The clinical measures were obtained before the first session and after 36 th session, using the Musculoskeletal Ultrasound (MSUS) to assess cartilage thickness. Results: There was a significant difference between MSUS before and after LIPUS treatment in left knee with p-value= 0.01. The mean MSUS increased from 1.81 to 2.27 with a difference 0.45 and in right knee with p-value=0.001. The mean MSUS increased from 2.09 to 2.44 with a difference 0.34. Conclusion: LIPUS has a statistical difference over increasing cartilage thickness measured by M.S.U.S in patient with mild to moderate knee osteoarthritis.