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Instability remains one of the leading causes of revision total hip arthroplasty. It is important to understand the etiology of recurrent instability prior to surgical intervention to solve instability. Understanding the patient factors and surgical factors that lead to instability is critical. Once the decision to have surgery has been made, it is critical to correct the problem that lead to instability. Today, several options exist to help reduce the risk of instability, but correction of component malposition is the most critical. This chapter reviews current options in the treatment of recurrent instability.

In the current healthcare environment, the postoperative treatment of patients who undergo total knee arthroplasty (TKA) is critical to successful outcomes, patient satisfaction, and controlling costs. Preemptive analgesia and the avoidance of excessive narcotics may help improve the outcomes and satisfaction of patients who undergo TKA because it allows for a more rapid rehabilitation program and reduces overall pain. Various techniques can be used to minimize the postoperative pain routinely observed in these patients. In addition, appropriate postoperative blood management may help minimize the need for transfusion and its associated risks. Such protocols, which involve the use of antifibrinolytic agents, appropriate knee positioning, and adjustment of transfusion triggers, have decreased the transfusion rate to 1% to 3% in patients who undergo routine primary TKA. The enhancement of patient satisfaction and the management of overall costs, which also must be considered in the perioperative medical management of these patients, includes appropriate control of diabetes mellitus, management of hyponatremia, and minimization of unnecessary workup of postoperative fever. The final aspect of postoperative treatment involves wound management, which includes how to best manage early wound drainage. Numerous types of surgical dressings are available for wound coverage, and surgeons should understand the risks, benefits, and costs of each type of surgical dressing. This cumulative knowledge may result in successful outcomes, increased patient satisfaction, and decreased costs for patients who undergo TKA.