Abstract Osteoarthritis is a disorder that leads to joint symptoms as a result of a gradual progressive breakdown of articular cartilage that appears to be irreversible. Hypertrophic changes occur at the margins of the joint surfaces and in the subchondral bone. The process usually continues until there is exposed bone at the surface of the joint. It is estimated that approximatelly 21 million Americans have symptoms related to osteoarthritis. Most are 65 years of age or older, and symptoms occur in 60% of men and 70% of women. The precise mechanism is unknown, but there is a general agreement that the destructive progress is mediated by altered chondrocyte activity. Osteoarthritis may exist for years without symptoms. Nonsurgical management options for osteoarthritis include education, physical therapy, medications, and local injections.

A number of surgical techniques can be considered in treating osteoarthritis of the glenohumeral joint. This article reviews the pathophysiology and clinical presentation of osteoarthritis of the glenohumeral joint, and discusses the surgical technique of total shoulder arthroplasty in detail. Video is available.

Abstract Unicompartmental osteoarthritis of the knee affects millions of individuals. Most nonsurgical management of this progressive disease is primarily directed at reducing inflammation and pain with medication. Evidence supports the clinical efficacy of bracing for managing osteoarthritis of the knee. In some patients, bracing significantly reduces pain, increases function, and reduces excessive loading to the damaged compartment. A variety of health and functional status instruments, as well as radiologic techniques and biomechanical investigations, has been used to evaluate the unloading capabilities of these braces. Although changes in angulation are relatively minimal, the braces have been shown to load share and thus reduce the stresses in the degenerated medial compartment of the knee.