Total hip replacement (THR) is a surgical procedure that involves replacing a damaged or diseased hip joint with an artificial implant. Traditionally, THR is performed through a posterior or lateral incision, which can result in a visible scar. However, in recent years, there has been a growing trend towards using a bikini incision for THR, also known as a bikini line or anterior incision. This approach aims to minimise visible scarring and provide a more cosmetically appealing result.
The bikini incision for THR is made along the natural crease in the groyne area, extending horizontally towards the hip joint. The incision is typically around 4 to 6 inches long and is strategically placed to be hidden within the patient's underwear or bikini line. This location offers several advantages from a cosmetic perspective, as it minimises the visibility of the scar when the patient is wearing swimsuits, underwear, or low-rise clothing.
The procedure begins with the patient being placed under general anaesthesia to ensure they are comfortable and unconscious throughout the operation. The surgeon then makes the bikini incision and carefully accesses the hip joint. One of the primary benefits of this approach is that it allows the surgeon to access the joint without cutting or detaching any muscles or tendons. This muscle-sparing technique is known as a "minimally invasive" approach and can result in a faster recovery and reduced postoperative pain.
Once the joint is accessed, the damaged or diseased parts of the hip joint, including the ball (femoral head) and socket (acetabulum), are removed. They are replaced with prosthetic components that mimic the structure and function of a healthy hip joint. The new components are typically made of metal, ceramic, or a combination of both and are securely fixed in place using specialised surgical cement or through a press-fit technique that encourages bone growth into the implant.
After the new components are in place, the surgeon ensures that they fit together correctly, providing stability and a smooth range of motion. Any excess fluid or debris is flushed out, and the incision is carefully closed with stitches or staples. The surgical site is then dressed, and a sterile bandage is applied.
Following the surgery, the patient is taken to a recovery area where they are closely monitored for a short period before being transferred to a hospital room. Physical therapy is typically initiated soon after the surgery to help regain strength, mobility, and function in the hip joint. The recovery period varies from patient to patient but generally involves a combination of pain management, rehabilitation exercises, and gradual return to normal activities.
While the bikini incision for THR offers cosmetic advantages, it is worth noting that not all patients are suitable candidates for this approach. Factors such as the patient's anatomy, body mass index (BMI), and the specific condition of the hip joint may influence the choice of incision. Therefore, it is important for individuals considering THR to consult with an orthopaedic surgeon who can evaluate their specific situation and determine the most appropriate surgical approach.