Many approaches to the hip joint have been described. All have advantages and disadvantages. It is safe to say that at the present time the Smith-Peterson approach is used most widely by American orthopedic surgeons. This approach appears to give a maximum visualization of the hip joint with a minimum of operative trauma.
However, some disadvantages of the approach are inevitably apparent. There is often adherence of the scar to the iliac crest. Weakness of the gluteal muscles, particularly of the abductor and internal rotator muscles, is always present to some degree because of the reflection of the gluteal origins from the iliac surface. Hemorrhage is at times formidable with the section of muscles and tendons necessary to open the field. Institution of mobility of the joint is always delayed because of the necessity of allowing healing of the replaced soft tissues.
With the recent use of metal fixatives to