For many but not for all: the bikini incision direct anterior approach for total hip arthroplasty. A narrative review
Abstract Total hip arthroplasty (THA) has significantly improved the lives of patients with degenerative hip disorders. The direct anterior approach (DAA) is favored for its minimally invasive nature, leading to less postoperative pain and a faster recovery. The bikini incision (BI) approach was dev...
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| Format: | Article |
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SpringerOpen
2024-12-01
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| Series: | Journal of Orthopaedics and Traumatology |
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| Online Access: | https://doi.org/10.1186/s10195-024-00812-z |
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| author | Cesare Faldini Francesco Traina Federico Pilla Claudio D’Agostino Matteo Brunello Manuele Morandi Guaitoli Alberto Di Martino |
| author_facet | Cesare Faldini Francesco Traina Federico Pilla Claudio D’Agostino Matteo Brunello Manuele Morandi Guaitoli Alberto Di Martino |
| author_sort | Cesare Faldini |
| collection | DOAJ |
| description | Abstract Total hip arthroplasty (THA) has significantly improved the lives of patients with degenerative hip disorders. The direct anterior approach (DAA) is favored for its minimally invasive nature, leading to less postoperative pain and a faster recovery. The bikini incision (BI) approach was developed to enhance aesthetic outcomes while maintaining the clinical and functional benefits of the DAA. Despite its advantages, the BI technique presents challenges, controversies persist regarding its efficacy and safety, and there is no consensus within the medical community about its overall benefits. Incisions aligned with Langer’s lines, like the BI, promote better healing and minimal scarring. Studies indicate that BI patients report higher satisfaction with scar appearance and texture compared to traditional DAA patients. However, the BI carries a higher risk of lateral femoral cutaneous nerve (LFCN) injury, although most symptoms resolve within 6 months. For obese patients, the BI is associated with fewer complications, such as infections and delayed healing, compared to the conventional DAA, making it a safe and effective option. BI patients also experience better aesthetic outcomes and functional recovery, with reduced pain and itching. The BI technique in THA represents a significant advancement, offering improved aesthetic and wound-healing outcomes. The shift from the traditional DAA to the BI aligns with patient preferences for scars that are less visible and conspicuous. Despite the steep learning curve and risks, careful patient selection and refined surgical techniques can enhance the BI’s benefits. Future research should focus on long-term outcomes and comparative studies to further establish the BI’s efficacy and safety. As patient demand for aesthetically favorable surgeries grows, the BI is likely to become a preferred approach in THA. |
| format | Article |
| id | doaj-art-b2c87eabeb654d50abcdadd28af7303a |
| institution | DOAJ |
| issn | 1590-9999 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Orthopaedics and Traumatology |
| spelling | doaj-art-b2c87eabeb654d50abcdadd28af7303a2025-08-20T02:40:15ZengSpringerOpenJournal of Orthopaedics and Traumatology1590-99992024-12-0125111010.1186/s10195-024-00812-zFor many but not for all: the bikini incision direct anterior approach for total hip arthroplasty. A narrative reviewCesare Faldini0Francesco Traina1Federico Pilla2Claudio D’Agostino3Matteo Brunello4Manuele Morandi Guaitoli5Alberto Di Martino6Department of Orthopedics and Traumatology, IRCCS Istituto Ortopedico RizzoliDepartment of Biomedical and Neuromotor Science—DIBINEM, University of BolognaDepartment of Orthopedics and Traumatology, IRCCS Istituto Ortopedico RizzoliDepartment of Biomedical and Neuromotor Science—DIBINEM, University of BolognaDepartment of Orthopedics and Traumatology, IRCCS Istituto Ortopedico RizzoliDepartment of Orthopedics and Traumatology, IRCCS Istituto Ortopedico RizzoliDepartment of Orthopedics and Traumatology, IRCCS Istituto Ortopedico RizzoliAbstract Total hip arthroplasty (THA) has significantly improved the lives of patients with degenerative hip disorders. The direct anterior approach (DAA) is favored for its minimally invasive nature, leading to less postoperative pain and a faster recovery. The bikini incision (BI) approach was developed to enhance aesthetic outcomes while maintaining the clinical and functional benefits of the DAA. Despite its advantages, the BI technique presents challenges, controversies persist regarding its efficacy and safety, and there is no consensus within the medical community about its overall benefits. Incisions aligned with Langer’s lines, like the BI, promote better healing and minimal scarring. Studies indicate that BI patients report higher satisfaction with scar appearance and texture compared to traditional DAA patients. However, the BI carries a higher risk of lateral femoral cutaneous nerve (LFCN) injury, although most symptoms resolve within 6 months. For obese patients, the BI is associated with fewer complications, such as infections and delayed healing, compared to the conventional DAA, making it a safe and effective option. BI patients also experience better aesthetic outcomes and functional recovery, with reduced pain and itching. The BI technique in THA represents a significant advancement, offering improved aesthetic and wound-healing outcomes. The shift from the traditional DAA to the BI aligns with patient preferences for scars that are less visible and conspicuous. Despite the steep learning curve and risks, careful patient selection and refined surgical techniques can enhance the BI’s benefits. Future research should focus on long-term outcomes and comparative studies to further establish the BI’s efficacy and safety. As patient demand for aesthetically favorable surgeries grows, the BI is likely to become a preferred approach in THA.https://doi.org/10.1186/s10195-024-00812-zTotal hip arthroplastyMinimally invasiveBikini incision approachDirect anterior approachHipLateral femoral cutaneous nerve |
| spellingShingle | Cesare Faldini Francesco Traina Federico Pilla Claudio D’Agostino Matteo Brunello Manuele Morandi Guaitoli Alberto Di Martino For many but not for all: the bikini incision direct anterior approach for total hip arthroplasty. A narrative review Journal of Orthopaedics and Traumatology Total hip arthroplasty Minimally invasive Bikini incision approach Direct anterior approach Hip Lateral femoral cutaneous nerve |
| title | For many but not for all: the bikini incision direct anterior approach for total hip arthroplasty. A narrative review |
| title_full | For many but not for all: the bikini incision direct anterior approach for total hip arthroplasty. A narrative review |
| title_fullStr | For many but not for all: the bikini incision direct anterior approach for total hip arthroplasty. A narrative review |
| title_full_unstemmed | For many but not for all: the bikini incision direct anterior approach for total hip arthroplasty. A narrative review |
| title_short | For many but not for all: the bikini incision direct anterior approach for total hip arthroplasty. A narrative review |
| title_sort | for many but not for all the bikini incision direct anterior approach for total hip arthroplasty a narrative review |
| topic | Total hip arthroplasty Minimally invasive Bikini incision approach Direct anterior approach Hip Lateral femoral cutaneous nerve |
| url | https://doi.org/10.1186/s10195-024-00812-z |
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