Many different surgical incisions approaches exist. Often these approaches are dictated by what the surgeon is most comfortable and experienced in, as well as the most appropriate for the required procedure. Here we will describe the most common surgical approaches for total hip replacement, as well as the most common cases which use each specific approach.

The Posterior approach is most commonly used for the replacement of the hip joint. The Posterior incision occurs at the top of the operating side buttock, and proceeds in a long arch path down the side of the thigh.

The Bauer Transgluteal Approach is most commonly used for femoral neck fractures, femoral neck osteotomies, total hip replacement, and cases of slipped epiphysis. The Bauer incision occurs on the side of the thigh, with the patient lying on his back on the operating table. The incision travels from just below the top of the pelvis and extends down the side of the thigh. A cushion is often placed underneath the patients buttocks.

The Anterolateral Approach is similar to the Bauer Transgluteal Approach, but the incision starts at the greater trochanter on the femur, and extends downward along the side of the thigh. This approach is more common in patients who require a hip pinning. The hip joint area is not easily accessed using this approach.

The Anterior Approach has been called the most versatile, yet most challenging approach to the hip. It provides broad exposure to the hip, for patients who have severe degenerative hip disease or trauma to the joint. The incision occurs in a quarter circle shape around the side of the thigh, starting at the edge of the Iliac crest and progressing upwards towards the front of the thigh.