The Evolution of Anterior Total Hip Arthroplasty The Past, Present, and Future

The anterior approach has become a widely used and accepted approach for total hip arthroplasty (THA). This approach offers a number of advantages including supine positioning, improved soft tissue management, and avoidance of taking down posterior structures. The approach has evolved significantly from its introduction in the late 19th Century due to advancements in technology. Specifically, developments in the table used for the approach, safer instrumentation, and fluoroscopic guidance with overlay technologies have helped the anterior approach gain popularity. This article reviews the evolution of the usage of the anterior approach, including the use of current and emerging technologies as well as the learning curve associated with switching to the anterior THA and the future of outpatient anterior THA.