[ANTERIOR HIP ARTHROPLASTY: EVOLUTION, REVOLUTION, OR AN ELAPSING TREND?]

Over the years total hip arthroplasty had turned from a procedure indicated for elderly, low functioning patients, into a procedure indicated also for younger patients who are interested in a well-functioning hip joint to maintain their active lifestyle. Previously, posterior approach was most commonly utilized, however in recent years, due to the accumulating evidence regarding the advantages of the anterior approach, an increase in the prevalence of the anterior approach is noted. In contrast to other surgical approaches, the anterior approach "respects" inter-muscular and inter-nervous planes and therefore is perceived as associates with less pain, faster rehabilitation, and a good stability relative to other approaches. Thus, the anterior approach received the attention of both the orthopedic community and the patients who are interested in maintaining their active life routine. In contrast to the advantages associated with the anterior approach, there are some disadvantages that are unique to this approach such as technical difficulties, a challenging learning curve, and a relatively common impairment of the sensation of the lateral aspect of the operated thigh. Due to the increasing rates of total hip arthroplasty procedures that are performed via the anterior approach, there is a need for reviewing the different aspects of this approach. The aim of this review is to discuss the principles of the anterior approach, the outcomes and complications.