The association between shoulder instability and the development of glenohumeral osteoarthritis has not been well studied in the literature. It is clear that some degree of chondral damage is associated with instability, and there appears to be an increased risk of developing symptomatic osteoarthritis and ultimately requiring a shoulder arthroplasty in patients with a history of instability. More study is needed to define the relationship between the early onset of radiographically or arthroscopically diagnosed arthritic changes and clinically significant osteoarthritis. Surgical procedures to correct instability are known to put patients at risk for glenohumeral arthritis if they limit external rotation or if hardware migrates into the joint. Total shoulder replacement is an appropriate treatment for advanced, symptomatic osteoarthritis arising in shoulders with a history of instability. Outcomes are generally satisfactory, although not as good as in patients with primary osteoarthritis, and there is a higher risk of revision surgery.