becoming a more extensile approach if needed. Critics cite a higher dislocation rate, although repair of the capsule, piriformis and the short external rotators along with use of modern large diameter head balls reduces this risk. Limited evidence suggests that the posterior approach may cause less nerve damage. Lateral approach The lateral approach is also commonly used for hip replacement. The approach requires elevation of the hip abductors (gluteus medius and gluteus minimus) to access the joint. The abductors may be lifted up by osteotomy of the greater trochanter and reapplying it afterwards using wires (as per Charnley), or may be divided at their tendinous portion, or through the functional tendon (as per Hardinge) and repaired using sutures. Although this approach has a lower dislocation risk than the posterior approach, critics note that occasionally the abductor muscles do not heal back on, leading to pain and weakness which is often very difficult to treat. Antero-lateral approach The anterolateral approach develops the interval between the tensor fasciae latae and the gluteus medius. The Gluteus medius, gluteus minimus and hip capsule are detached from the anterior (front) for the greater trochanter and femoral neck and then repaired with heavy suture after the replacement of the joint. Anterior approach The anterior approach uses an interval between the sartorius muscle and tensor fasciae latae. Dr. Joel Matta and Dr. Bert Thomas have adapted this approach, which was commonly used for pelvic fracture repair surgery, for use when performing hip replacement. When used with older hip implant systems that had a small diameter head, dislocation rates were reduced compared to surgery performed through a posterior approach. With modern implant designs, dislocation rates are similar between the anterior and posterior approaches. The anterior approach has been shown in studies to variably improve early functional recovery, with possible complications of femoral component loosening and early revision compared to other approaches. Minimally invasive approaches The dual incision approach and other minimally invasive surgery seeks to reduce soft tissue damage through reducing the size of the incision. However, component positioning accuracy and visualization of the bone structures can be significantly impaired as the approaches get smaller. This can result in unintended fractures and soft tissue injury. The majority of current orthopedic surgeons use a "minimally invasive" approach compared to traditional approaches which were quite large comparatively. Computer-assisted surgery and robotic surgery techniques are also available to guide the surgeon