Journal of the American Academy of Orthopaedic Surgeons December 2007, Volume 15, Issue 12 Minimal Incision Total Hip Arthroplasty Copyright © 2007 by the American Academy of Orthopaedic Surgeons. Thomas P. Vail, MD, MBA and John J. Callaghan, MD Dr. Vail is Professor and Chairman, Department of Orthopaedic Surgery, University of California, San Francisco, CA. Dr. Callaghan is Lawrence Dorr Professor of Orthopaedic Surgery, Department of Orthopaedic Surgery, University of Iowa, Iowa City, IA. Dr. Vail or a member of his immediate family has received research or institutional support from DePuy, Zimmer, Smith & Nephew, and Wright Medical, and has received royalties from DePuy and Zimmer. Dr. Callaghan or a member of his immediate family has received research or institutional support from DePuy and has received royalties from DePuy. Reprint requests: Dr. Vail, Department of Orthopaedic Surgery, University of California, San Francisco, 500 Parnassus Avenue, MU320 W, San Francisco, CA 94143-0728. Although debate regarding minimally invasive hip surgery is inconclusive, information published to date on the risks and benefits of small-incision approaches focuses the discussion on quality and outcomes. Small-incision surgical approaches include the posterior, anterolateral, direct anterior, and two-incision approach. Computer navigation assists in mapping hip replacement surgery. Obesity is a risk factor and has been found to increase complications. Patient education, pain management, and rehabilitation are important to recovery after minimal incision hip arthroplasty. Total hip replacement may be successfully achieved via smaller incisions, but functional improvement, discharge to home, patient satisfaction, and analgesic requirement may be similar regardless of the length of the incision.