The ARCH Table Extension is an economical, leg-holding traction device that facilitates surgeries, including Anterior Total Hip Replacement, through advanced and easy patient positioning. Additional value may be realized through its use in hip and femur fracture cases and hip arthroscopy. The ARCH is placed at the foot end of any brand of surgical table. The patient's foot is positioned in the ARCH's traction boot. The foot and traction boot are then connected to, and move along, the device frame. Optimal leg positioning, including hyperextension, abduction and external rotation, can be achieved with constant, measurable, safe traction and precise reference points.