The traditional

Total hip arthroplasty, is a procedure that has been developed since the sixties being the best solution we have today to recover joint function as a surgical act that is aimed at the existing based on a principle in the experience of the surgeon in the approach used, the agility with which he handles the way and knowledge of this, the resistance and bone fixation of the material and the instruments used, demanding from the surgeon precision in the distribution of the load during the surgical act (Biomechanics) and the analysis of the trabecular resistance limit to maintain the fixation of these artificial implants and their high coefficients of friction that surpass in more than seventy (70) times the physiological ones limiting their results; causing loosening and wear of the materials, with serious osteolysis problems.

It is very frequent to observe the direct lateral approach to the hip described by Hardinge in 1982 in eighty-three arthroplasties, found as excellent in the exposure of the proximal femur and acetabulum, being described with shorter operating times, minimal blood loss and wandering times with very low dislocation rates.

The anterior hip approach has shown significant differences with those described above, given from the way the patient is placed on the operating table that is made in lateral decubitus and the surgical incision is made laterally, straight and centered on the greater trochanter continuing into the subgluteal space where the tendon insertion of the minor gluteus is incited in the form of inverted "C." The patient is placed on the operating table that is made in lateral decubitus and the surgical incision is made laterally, straight and centered on the greater trochanter, continuing into the subgluteal space where the tendon insertion of the minor gluteus is incited in the form of inverted "C", thus entering, in an indirect way to the hip, respecting the gluteus medius and the vast lateral, not injuring any muscle fiber of those mentioned since with the previous approaches these compromise the integrity of these muscles in a direct or indirect way in the articular entrance, so that with this approach there is no deficit of these muscle groups resulting in less time for ambulation and greater abductor force. In addition, an anterior capsulotomy is performed, which is performed from the lower edge of the acetabular impeller in an "L" shape, thus allowing anatomical closures after the intervention. A considerable reduction in the length of the surgical incision is shown using mini-incisions of 6 - 10 centimeters, adding a favorable component to this option more of approach in the morbidity of the conventional hip surgery, associated to a greater aesthetic acceptance in the cicatrization of the patients; since in the conventional surgeries the incisions according to the reported works vary between 20 and 24 centimeters.

The direct anterior approach is an intermuscular approach which favors a rapid recovery of the patient. The advantages of this approach are: a) excellent exposure of the acetabulum, b) possibility of measuring the length of the limbs given that the patient is in the supine position, being the safest method, c) an intraoperative radiographic control can be performed if necessary, d) the prosthetic stability achieved since the only thing that is sectioned is the anterior capsule preserving the pelvic-rotators and the posterior capsule.

As disadvantages we could mention the greater technical difficulty to perform the procedure, which we must have specific instruments, both separators and femoral scraper holders.