Mr Freedman - Orthopaedic Surgeon
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This is a variation on the muscle-sparing anterior approach for hip replacement, in which the surgical scar is aesthetically hidden within the skin fold of the “bikini line” or frontal groin crease. The surgical scar is, therefore, not visible when wearing underwear or swimwear.
The only difference between the bikini hip replacement surgical technique and the more traditional anterior approach is the placement and orientation of the skin incision, Below the skin layer, the operation is performed in exactly the same way as for other anterior hip replacement.
The usual anterior hip replacement is already short and neat and most patients who undergo hip replacement are not particularly concerned by the position or direction of the scar.
Nevertheless, the bikini hip replacement technique is is useful for young women or any other patients keen to achieve a “no visible scar” (below the bikini/underwear line).
The bikini/groin scar surgical technique was developed by Dr Frederic Laude (Orthopaedic Surgeon in Paris) and further popularised by Dr Michael Leunig (Orthopaedic Surgeon in Switzerland). Mr Freedman has travelled to Switzerland and France to be trained in this technique and utilises this surgical approach in appropriate circumstances.
Mr Freedman does not advocate this approach for all anterior hip replacement patients. The orientation of the incision can limit surgical exposure in certain body shapes and not be ideal for all patients. At your consultation Mr Freedman will be able to advise you of the pros and cons of various surgical options and will be able to to recommend the most appropriate management for your hip problem.
If you are interested in learning more about the bikini incision technique for hip replacement please contact our rooms to make a clinical appointment.
Q: I am quite a large patient (body size( – am I still able to have a bikini/anterior hip replacement?
A: Generally speaking, the anterior approach is possible for most body shapes and body weight alone is usually not a determining factor as to what surgical approach is preferred. However, Mr Freedman may not advise an anterior approach or bikini incision for all patients. If you have a large abdomen to the point that your tummy hangs down over the front of your anterior thigh or if carry a lot of weight or extra skin in the upper thigh, you may be advised that the anterior approach is not favoured in your case as surgical access may be difficult or a large apron of skin at the front of the thigh may pose an infection risk for surgery through the anterior approach.
Similarly, if you carry extra weight or skin in the region of the groin crease, Mr Freedman may advise that he place the surgical incision away from the groin crease rather than within the groin crease.
Fortunately, Mr Freedman is trained in and performs all contemporary hip approaches and so be will be able to advise as to the safest and most appropriate technique for your surgery.
Q: I’ve seen another surgeon for an opinion and was told that the anterior approach is new and unproven. What do you say to that?
A: Mr Freedman disagree and feels that this view is misinformed. The anterior approach is relatively new to Australia but has been very firmly established in France, Switzerland and elsewhere in Europe for many years. If you were having a hip replacement in Paris (or Geneva or elsewhere in Europe) the surgeon would most likely use the anterior approach. The anterior approach has also rapidly gained in popularity in the United States in recent years.
I would be correct to say that most surgeons in Australia are untrained in and unfamiliar with the anterior approach. Mr Freedman consequently sought out specialised training in France and Switzerland to be able to offer this surgery to patients in Melbourne.
Q: What pain medication will I need to take after surgery?
A: We utilise an “Enhanced Recovery” programme to help you recover and rehabilitate quickly after surgery. With this programme most patients will not need to take strong pain killer tablets. Most patients will receive a special pain patch which is worn on the skin for a few days and only need to take the odd tablet for any breakthrough pain. More information on the Enhanced Recovery Programme (ERAS) can be found on the dedicated section on ERAS on this website.
For more information on anterior hip replacement or the “bikini” incision variation on the anterior hip replacement please contact our office to schedule an appointment.