Journal of Orthopaedics Trauma Surgery and Related Research

Journal of Orthopaedics Trauma Surgery and Related Research

An Official Journal of Polish Society of Orthopaedics and Traumatology

ISSN:1897-2276
e-ISSN: 2449-9145

Retrospective cohort study comparing the functional outcomes of direct anterior approach hip arthroplasty: Oblique bikini vs. longitudinal skin incision

Author(s): Richard Menzies Wilson*, Iskandar Tamimi Marino, Karuppiah Mahalingham and Richard Field

Introduction: The Direct Anterior Approach (DAA) has gained popularity in recent years. Numerous papers have suggested that short-term outcomes are advantageous over alternative approaches. The ‘bikini’ inguinal crease line incision is a novel variant of the DAA which leave the patient with a cosmetically better scar. We report a single surgeon’s experience of the operation and short-term outcomes.

Patients, Materials, and Methods: Patients undergoing a primary THR between 2013-2015 were included in the search. The operative time, Hb drop on day 1, flexion/abduction/strength at discharge and the 6-month change in Oxford and EuroQol scores were evaluated. This was done from patient notes and cloud-based outcomes collection software. Patients who were lost to follow-up at 6-months and had a bilateral THR were excluded.

Results: 89 patients met our inclusion criteria. The average length of operation was 1hr 34mins. The average Hb drop was 2.5 gm/dl on day 1. On discharge, the average abduction was 23 degrees and power was MRC grade 4.7. Between pre-operative and 6-month assessment the EuroQol score increased by 0.49 and the Oxford Hip score by 11.1.

Discussion: The increase in Oxford Hip and EuroQol scores at 6-months were similar to those of a cohort group who underwent a classical longitudinal-incision DAA. Average Hb drop is in line with published norms. The authors were unable to find published results on power and abduction on discharge after a THR for comparison. The operative time was slightly longer than the surgeon’s average for classical DAA THR’s. Conclusion: This novel ‘bikini-incision’ THR has similar outcomes scores to a classic longitudinal DAA. It offers a cosmetically better scar and so may have value in patients who are image conscious.


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Annals of Medical and Health Sciences Research Journal of Orthopaedics Trauma Surgery and Related Research a publication of Polish Society, is a peer-reviewed online journal with quaterly print on demand compilation of issues published.
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