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10 9 8 7 6 5 4 3 2 1 The surgical technique for total hip replacement has many kind of approach. It depends to the type of implant and surgeon experience. After the anesthesia of choice is established, the patient is placed in the lateral decubitus position with the operative side up. The skin and subcutaneous tissue are incised sharply down to the level of the fascia lata. The fascia lata and gluteal fascia are then incised sharply in line with the incision and after retracion of gluteal muscle flap posteriorly shows external rotators inserting of femur and dissect the tendinous insertion to expose the capsule. After the Reflection of the short rotator muscles exposes the hip capsule.  Expose the hip joint by creating and reflecting a full thickness, broad-based flap of the posterior hip capsule. Then we dislocate the hip and make an osteotomy of the neck an we remove the head of the femur. For acetabular preparation we need a Debridement for create cup space and acetabular reaming before insert the shell. Also femur need to be expose , a debridement for create space and the preparation of the canal before the stem insertion. At the end after the insertion of femoral head we reduce the head in the shell and test cthe stability and the range of motion.