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Bikini Incision vs Longitudinal Incision for Anterior Total Hip Arthroplasty: A Systematic Review.

Justin Butler1, Amy Singleton1, Richard Miller1

  • 1Mercy Health - St. Vincent Medical Center, Department of Orthopedics, Toledo, OH, USA.

Arthroplasty Today
|August 9, 2022
PubMed
Summary

The bikini incision for direct anterior approach total hip arthroplasty offers improved cosmesis and patient satisfaction compared to the traditional longitudinal incision. Functional hip outcomes are similar, though awareness of potential nerve injury is advised.

Keywords:
Bikini incisionDirect anterior approachLongitudinal incisionOblique incisionOutcomesTotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Reconstructive Surgery

Background:

  • Direct anterior approach total hip arthroplasty (DAA THA) traditionally uses a longitudinal incision.
  • A bikini incision may offer cosmetic and patient satisfaction benefits while reducing wound complications.

Purpose of the Study:

  • To systematically review and compare clinical outcomes and surgical complications of DAA THA using bikini versus longitudinal incisions.

Main Methods:

  • A systematic literature search was conducted across PubMed, Cochrane, and EMBASE for studies from 2010-2021.
  • Qualitative evaluation of patient demographics, scar appearance, satisfaction, functional scores, and complications from 8 comparative studies.

Main Results:

  • Bikini incisions showed improved scar appearance and patient satisfaction in 75% of studies.
  • Postoperative hip function was comparable between bikini and longitudinal incisions in 75% of studies.
  • Lateral femoral cutaneous nerve injury was the most common complication, with low overall rates and good resolution.

Conclusions:

  • Bikini incision is a safe alternative for DAA THA, potentially enhancing cosmesis and satisfaction with similar functional results.
  • Further prospective studies are needed to confirm the risk of lateral femoral cutaneous nerve injury with bikini incisions.