The development of safe and reliable surgical approaches to the hip has allowed successfully hip replacement surgery to take place. There are essentially five main approaches to the hip joint –anterior, anterolateral, direct lateral and posterior.Each main approach has several different variants described and some of these modifications can be confusing if you haven’t seen them firsthand at surgery.Each approach takes advantage of muscular planes around the hip.Each approach has inherent advantages and disadvantages.No approach can claim to be perfect
- The anterior approach utilizes the interval between the sartorius medially and tensor fascia laterally.
- The anterolateral approach uses the interval between the tensor fascia and the gluteus medius.
- The direct lateral approach is essentially dependent upon elevation of the insertion of the gluteus medius and minimus.
- The posterior approach involves detaching the short external rotators from the femur
- Anterolateral(Watson Jones)
- Direct lateral approach/transgluteal (Charnley approach,Hardinge)