Bikini Hip Replacement
A variation of the anterior approach with improved wound healing
An aesthetically hidden incision
Bikini Hip Replacement is a minimally invasive muscle-sparing procedure.
The procedure is a variation of the Direct Anterior approach and is performed via a skin incision within the skin fold of the ‘bikini line’ or frontal groin crease.
This incision was originally developed as a way to achieve an aesthetically pleasing scar. However, it has since been demonstrated that this incision also has a reduced risk of wound problems, as the wound edges are placed under less tension.
This procedure is conducted via an intermuscular (between muscles) and internervous (between nerves) pltne, with the patient lying on their back. This allows the surgeon to approach the hip joint between the front muscles of the hip and eliminates the need to detach muscles on the side or back of the hip. This leads to faster recovery and less post-operative discomfort.
The use of real-time X-rays during the procedure helps to achieve correct placement of the implant and accurate leg length.
A range of benefits
Advantages of the bikini hip replacement include:
- Less Visible Scar: The incision along the bikini line crease makes scars less noticeable, benefiting those concerned about scar visibility.
- Reduced Risk of Wound Problems: The wound edges are under less tension and so the bikini incisions tend to have low risk of wound problems.
- Rapid Recovery
With less muscle trauma and a smaller incision, patients typically enjoy a quicker recovery and faster return to normal activities. - Shorter Post-Operative Restrictions: As this approach is minimally invasive, patients generally do not need crutches fore than a few days afterwards, and will be able to sit in regular chairs, cross their legs, and sleep on their sides from Day 1 post surgery.
- Reduced Discomfort and Medication: As no major muscles are released, post-operative discomfort and the requirement for pain medication are reduced. Avoidance of strong opiate pain medications minimises nausea, drowsiness, and constipation caused by use of strong analgesics.
- Faster Rehabilitation: Improved post-operative stability compared to traditional hip replacements leads to quicker rehabilitation and return to normal activities.
- Preserved Posterior Capsule: By accessing the hip from the front (anterior), the posterior capsule at the back of the hip doesn’t need to be opened, which greatly reduces the risk of posterior dislocation (near zero).
Case Examples
Frequently asked questions
The anterior approach for hip replacement is possible for most body shapes. Body weight alone is usually not a determining factor as to what surgical approach is preferred.
Mr Freedman may, however, not advise a bikini incision if you have a particularly large abdomen (tummy) that hangs well down over the front of your thigh. A large apron of skin at the front of the thigh may pose an infection risk for surgery through the anterior approach. Mr Freedman endeavours to offer the anterior approach for most patients but will have an honest conversation with you if a different approach is suggested. Mr Freedman is trained in and performs all contemporary hip approaches and so will be able to advise as to the safest and most appropriate technique for your surgery.
Mr Freedman completely disagrees and feels that this view is grossly misinformed.
The anterior approach is relatively new to Australia but has been firmly established in France, Switzerland and elsewhere in Europe for many years. If you were having a hip replacement in Paris (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.
It 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.
Wound numbness may occur in all surgical approaches. With the anterior approach there an incision is made on the anterior (front) aspect of the upper thigh. There are a small sensory nerve branches which runs in the front of the thigh. Sometimes branches of these sensory nerves may be stretched or incised during surgery, leading to an area of numbness or sensitivity. This usually diminishes over time and is seldom an ingoing concern to patients.
Not very much at all. 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 for more than a few days. We use cryotherapy (ice packs) and nerve blocks to provide good pain relief without needing to use much pain medication.
Absolutely. Male patients are absolutely able to have their hip replacement through this technique. The technique is nicknamed “the bikini approach” because the incision runs in the groin crease, but this can be performed on men as well.