Introduction

A bikini incision hip replacement is a minimally invasive hip replacement procedure in which the damaged hip joint is replaced with implants through a small diagonal incision made at the front of the hip. The surgical scar formed as a result of this technique is small enough to be concealed by a bikini, hence the name.

Indications

Bikini incision hip replacement is typically recommended for younger active patients and those who prioritize cosmetic outcomes. The procedure can be suitable for patients who are in good health, have no severe hip deformities, and who require the hip replacement due to conditions like osteoarthritis. However, not all surgeons are trained in this specific technique, and it may not be appropriate for all patients.

Preparation

Preoperative preparation for a bikini incision hip replacement includes:

• A comprehensive medical evaluation including blood tests and imaging studies to evaluate the patient's overall health, hip anatomy, the extent of any joint damage, and to help plan the procedure.
• Informing your doctor of any allergies to medications, anesthesia, or latex.
• Providing your physician with a list of any medications or supplements you are taking. You may need to adjust or temporarily stop taking certain medications, especially those that can affect blood clotting.
• Disclosing any recent illnesses or other medical conditions you may have.
• Stopping smoking as it can impact the healing process and increase the risk of complications.
• Abstaining from food or drink for at least 8 hours prior to the surgery.

Surgical Procedure

In general, bikini incision hip replacement surgery may involve the following steps:

• General or regional anesthesia will be administered.
• You will be lying on your back on a special operating table.
• A short oblique incision, the bikini incision is made in the crease of the groin.
• The tissue and underlying muscles are carefully moved aside to gain access to the joint and perform the replacement.
• The thigh bone (femur) is separated from the hip socket (acetabulum).
• The acetabular surface is prepared using a special instrument called a reamer.
• The acetabular component is cemented or fixed with screws into the socket.
• Then a liner which can be plastic, metal, or ceramic is placed inside the acetabular component.
• The damaged portion of the femoral head is excised or removed, and the femur is prepared using special instruments so that the new metal component fits into the bone properly.
• The new femoral component is inserted into the femur, either by a press fit or by using special bone cement.
• The femoral head component, which is ceramic or metal, is then placed on the femoral stem.
• Once the artificial components are fixed in place, the instruments are withdrawn, and the incisions are closed with sutures and covered with a sterile dressing.

Post-operative Care

After surgery, you will be transferred to the recovery area where you will rest until you are discharged. Patients typically stay in the hospital for 1 to 3 days, depending on their recovery progress. Most patients can resume normal activities within 6 to 12 weeks, although full recovery may take longer. Follow-up appointments are scheduled to monitor the healing process and to ensure proper joint function. You will also be given post-operative advice and instructions on the following:

• The use of assistive devices for walking such as a cane or crutches.
• Limited weight bearing activities.
• Suture and dressing care.
• Strict adherence to a physical therapy and exercise regimen to improve hip range of motion and to strengthen the hip muscles.
• Dietary changes and supplements to improve bone health.
• Adherence to prescribed medications.

Risks and Complications

As with any surgery, there are risks of infection, blood clots, or complications related to anesthesia. There is also a possibility of nerve or blood vessel injury due to the proximity to the femoral nerve and blood vessels.

Benefits

Some of the benefits of a bikini incision hip replacement surgery include:

• Minimal tissue damage, less pain.
• Better wound healing.
• Faster recovery.
• Desirable cosmetic results due to the discrete location of the surgical incision in alignment with the skin crease.

Summary

Bikini incision hip replacement is a minimally invasive surgical approach used in a hip replacement procedure. It is named for the location and orientation of the incision, which is made in the groin area following the natural crease of the bikini line. The technique is designed to minimize visible scarring and improve cosmetic outcomes, especially for those patients concerned about the appearance of scars.