Faldini Cesare, Traina Francesco, Pilla Federico, D'Agostino Claudio, Brunello Matteo, Morandi Guaitoli Manuele, Di Martino Alberto
Department of Orthopedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, Bologna, Italy.
Department of Biomedical and Neuromotor Science-DIBINEM, University of Bologna, Bologna, Italy.
J Orthop Traumatol. 2024 Dec 18;25(1):66. doi: 10.1186/s10195-024-00812-z.
Total hip arthroplasty (THA) has significantly improved the lives of patients with degenerative hip disorders. The direct anterior approach (DAA) is favored for its minimally invasive nature, leading to less postoperative pain and a faster recovery. The bikini incision (BI) approach was developed to enhance aesthetic outcomes while maintaining the clinical and functional benefits of the DAA. Despite its advantages, the BI technique presents challenges, controversies persist regarding its efficacy and safety, and there is no consensus within the medical community about its overall benefits. Incisions aligned with Langer's lines, like the BI, promote better healing and minimal scarring. Studies indicate that BI patients report higher satisfaction with scar appearance and texture compared to traditional DAA patients. However, the BI carries a higher risk of lateral femoral cutaneous nerve (LFCN) injury, although most symptoms resolve within 6 months. For obese patients, the BI is associated with fewer complications, such as infections and delayed healing, compared to the conventional DAA, making it a safe and effective option. BI patients also experience better aesthetic outcomes and functional recovery, with reduced pain and itching. The BI technique in THA represents a significant advancement, offering improved aesthetic and wound-healing outcomes. The shift from the traditional DAA to the BI aligns with patient preferences for scars that are less visible and conspicuous. Despite the steep learning curve and risks, careful patient selection and refined surgical techniques can enhance the BI's benefits. Future research should focus on long-term outcomes and comparative studies to further establish the BI's efficacy and safety. As patient demand for aesthetically favorable surgeries grows, the BI is likely to become a preferred approach in THA.
全髋关节置换术（THA）显著改善了髋关节退行性疾病患者的生活。直接前路手术（DAA）因其微创性而受到青睐，术后疼痛较轻且恢复较快。比基尼切口（BI）手术的开发旨在提高美学效果，同时保持DAA的临床和功能优势。尽管具有这些优点，但BI技术仍存在挑战，其疗效和安全性仍存在争议，医学界对于其整体益处尚未达成共识。与朗格线对齐的切口，如BI，能促进更好的愈合和最小的疤痕形成。研究表明，与传统DAA患者相比，BI患者对疤痕外观和质地的满意度更高。然而，BI导致股外侧皮神经（LFCN）损伤的风险更高，尽管大多数症状在6个月内会消失。对于肥胖患者，与传统DAA相比，BI的并发症（如感染和愈合延迟）较少，使其成为一种安全有效的选择。BI患者还能获得更好的美学效果和功能恢复，疼痛和瘙痒减轻。THA中的BI技术是一项重大进展，能改善美学和伤口愈合效果。从传统DAA向BI的转变符合患者对不那么明显和显眼的疤痕的偏好。尽管学习曲线陡峭且存在风险，但仔细的患者选择和精细的手术技术可以增强BI的益处。未来的研究应关注长期结果和比较研究，以进一步确定BI的疗效和安全性。随着患者对美观手术的需求增加，BI可能会成为THA中的首选方法。
