Background Muscle-sparing techniques, more consistent acetabular component positioning with fluoroscopy guidance, development in implants and instrumentation, expedited rehabilitation, and patients’ expectations have led to increased utilization of various direct anterior and anterolateral approaches to the hip joint. Methods and surgical technique In this technical note, we demonstrate for the first time a hybrid modification of traditional Smith-Peterson and Watson-Jones approaches to the hip joint on a standard operating room (OR) table. Conclusions As demonstrated in this article, a precise knowledge of anatomy and clear goals in the surgical approach can minimize complications and facilitate visualization and instrumentation placement in the “direct anterior approach” to the hip joint.

Background: Muscle-sparing, more consistent acetabular component positioning with fluoroscopy guidance, development in implants and instrumentation, expedited rehabilitation, and patients’ expectations have led to increased utilization of various direct anterior and anterolateral approaches to the hip joint. Methods and Surgical Technique: In this technical note, we demonstrate for the first time a hybrid modification of traditional Smith-Peterson and Watson-Jones approaches to the hip joint on a standard OR table. Conclusions: As demonstrated in this article, a precise knowledge of anatomy and clear goals in the surgical approach can minimize complications and facilitate visualization and instrumentation in the “direct anterior approach” to the hip joint