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Clinical Orthopaedics and Related Research®

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01-07-2013 | Surgical Technique

Skin Crease ‘Bikini’ Incision for Anterior Approach Total Hip Arthroplasty: Surgical Technique and Preliminary Results

Authors: Michael Leunig, MD, Michael Faas, MD, Fabian von Knoch, MD, Florian D. Naal, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 7/2013

Abstract

Background

The direct anterior approach for THA allows implantation through an internervous plane without muscle detachment from bone. However, the classic longitudinal skin incision does not follow the anatomic skin creases and can result in scar widening. We therefore modified our incision technique to a short oblique skin incision following the anatomic skin crease of the groin.

Questions/purposes

We sought to determine whether (1) the oblique incision leads to improved scar results compared with the longitudinal incision, (2) functional and pain scores are similar between the two approaches, and (3) the new incision is safe with respect to complications, blood loss, implant position, and lateral femoral cutaneous nerve (LFCN) symptoms.

Methods

Fifty-nine patients underwent THAs using either the classic (n = 33) or the new oblique incision (n = 26). At 6 months after surgery, we compared objective and subjective scar results, WOMAC, Oxford Hip and UCLA scores, blood loss, cup inclination, and the presence of LFCN symptoms between both groups.

Results

Objectively, the modified incision resulted in significantly shorter and narrower scars. Subjectively, patients in the modified incision group were substantially more satisfied with the aesthetic appearance. Functional and pain scores were similar. No complications occurred in either group. Blood loss and cup inclination did not differ between the two groups. There were no differences in LFCN symptoms.

Conclusions

In this series, which selected for thinner patients in the study group, the ‘bikini’ incision for an anterior approach THA led to improved scar cosmesis and was found to be safe in terms of blood loss, appropriate component placement, and risk for LFCN injury.

Level of Evidence

Level III, retrospective comparative study. See the Guidelines for Authors for a complete description of levels of evidence.

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Title: Skin Crease ‘Bikini’ Incision for Anterior Approach Total Hip Arthroplasty: Surgical Technique and Preliminary Results
Authors: Michael Leunig, MD
Michael Faas, MD
Fabian von Knoch, MD
Florian D. Naal, MD
Publication date: 01-07-2013
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 7/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-013-2806-0

At a glance: The STEP trials

Springer Medicine

Skin Crease ‘Bikini’ Incision for Anterior Approach Total Hip Arthroplasty: Surgical Technique and Preliminary Results

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

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