A method of total hip arthroplasty using a direct anterior approach to prepare an acetabulum of a patient for implantation of an acetabular cup implant, the method including providing a positioning instrument, forming a main incision substantially over the acetabulum, the main incision having a length of about the size the acetabular shell to be implanted, placing the positioning instrument in the main incision such that the shell of the positioning instrument rests in said acetabulum of the patient, and using a guide bore of the instrument to locate and form a portal incision, the portal incision communicating with the main incision. A cannula is inserted through the portal incision, such that a proximal end of the cannula extends from the portal incision and a distal end of the cannula is adjacent to and in communication with the acetabulum and main incision. The cannula is used to prepare the acetabulum and implant the final implant.
