Despite improved understanding of carpal mechanics, increased awareness of intercarpal ligament injuries, and improved techniques for treating carpal instability, post-traumatic intercarpal osteoarthrosis remains a common problem. Osteoarthritis of the carpal bones, including scapholunate advance collapse wrist, scaphotrapeziotrapezoid arthritis, lunotriquetral arthritis, triquetrohamate arthritis, and pisotriquetral arthritis, follows specific unique patterns, but in each, the final common pathway leads to degenerative change. Injury or deformity leads to instability and altered kinematics, producing abnormal joint contact pressures. Cartilage injury and eventual degeneration of the join follow. The etiology, prevalence, and current evaluation and treatment of these conditions are of importance to hand surgeons.