Bikini vs Longitudinal Incision for Total Hip Arthroplasty

Overseen By Victor H Hernandez, MD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Miami

Disqualifiers: BMI < 30, Prior hip surgery, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: Up to 3 hours

110 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how two types of incisions affect recovery and satisfaction in hip replacement surgery. Researchers compare the "bikini incision" and the "longitudinal incision" to determine which one promotes better wound healing and increases patient satisfaction post-surgery. Eligible participants are those with a body mass index of 30 or more undergoing their first hip replacement. As an unphased trial, this study provides patients the chance to contribute to valuable insights that could enhance surgical outcomes for future patients.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that these incision techniques are safe for total hip arthroplasty?

Research shows that both bikini and longitudinal cuts are generally safe for hip surgery, though they carry different risks. Studies indicate that the bikini cut can be performed safely and often results in a shorter hospital stay. Initially, the complication rate was 20.8%, but it dropped to 7.6% as surgeons gained experience, making the bikini cut safer over time.

The longitudinal cut is also well-tolerated. However, one study found that 3.1% of patients required additional surgery to close the wound, and 16.9% needed further operations. Despite these issues, the bikini cut is considered a safe option with results similar to the longitudinal cut.

In summary, both types of cuts are generally safe, but the bikini cut might offer benefits like shorter hospital stays, especially as surgeons become more experienced. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the trial comparing bikini and longitudinal incisions for total hip arthroplasty (THA) because it could lead to advancements in surgical techniques. The bikini incision, placed in a more cosmetically appealing area, might offer benefits in terms of faster recovery, less visible scarring, and potentially fewer complications compared to the traditional longitudinal incision. This trial aims to see if these aesthetic and recovery benefits hold true, which could make a significant difference in patient satisfaction and overall outcomes from hip replacement surgeries.

What evidence suggests that this trial's incision techniques could be effective for wound healing and participant satisfaction?

This trial will compare the bikini incision with the longitudinal incision for total hip arthroplasty. Research has shown that the bikini incision for hip replacement surgeries often leads to better-looking results and higher patient satisfaction. Studies have found that this method usually results in shorter scars and better wound healing. Participants in this trial may receive the bikini incision. Conversely, the traditional longitudinal incision, which another group of participants will receive, is also effective and safe. Some studies have noted it can help manage early complications more easily. Both incision types are linked to successful hip replacement outcomes, but the bikini incision might offer a slight advantage in appearance and healing for some patients. ^{1 2 3 4 6}

Who Is on the Research Team?

Victor H Hernandez, MD

Principal Investigator

University of Miami

Are You a Good Fit for This Trial?

This trial is for individuals undergoing Total Hip Arthroplasty (THA) using the Direct Anterior Approach (DAA). Specific eligibility criteria are not provided, but typically participants would be adults in need of hip replacement who meet surgical requirements.

Inclusion Criteria

I am scheduled for a first-time hip replacement surgery.

I am having a hip replacement on one side.

My BMI is 30 or higher.

Exclusion Criteria

Patients with body mass index less than 30

I cannot or do not want to have spinal anesthesia.

I am allergic or cannot take certain drugs used in the University of Miami's hip replacement protocol.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo total hip arthroplasty with either a bikini or longitudinal incision

Up to 3 hours

1 visit (in-person)

Follow-up

Participants are monitored for wound healing, scar cosmesis, patient satisfaction, and postoperative complications

Up to 6 months

What Are the Treatments Tested in This Trial?

Interventions

• Bikini Incision
• Longitudinal Incision

Trial Overview The study compares wound healing and patient satisfaction between two types of incisions: a bikini incision and a longitudinal incision, both performed during THA via DAA. The goal is to determine if one results in better outcomes.

How Is the Trial Designed?

Group I: Longitudinal Incision Group Experimental Treatment 1 Intervention

Participants in this group will receive the longitudinal incision during THA. Total participation is up to 90 days.

Group II: Bikini Incision Group Experimental Treatment 1 Intervention

Participants in this group will receive the bikini incision during THA. Total participation is up to 90 days.

Who Is Running the Clinical Trial?

University of Miami

Lead Sponsor

Trials

976

Recruited

423,000+

Citations

1. sicot-j.org sicot-j.org/articles/sicotj/full_html/2025/01/sicotj240145/sicotj240145.html

Safety and outcomes of bikini-incision DAA for hip ... This study reports the complications encountered during bikini-incision DAA THA performed by a single surgeon using a standard operating table.

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/40233248/

Safety and outcomes of bikini-incision DAA for hip ... The bikini-incision DAA THA using a standard operating table provides excellent short- to mid-term functional outcomes and implant ...

3. nature.com nature.com/articles/s41598-023-29146-2

Comparison of postoperative outcomes between bikini ... The bikini-incision method yields a shorter length of the scar, better wound healing, and higher satisfaction due to the alignment of the ...

4. jorthoptraumatol.springeropen.com jorthoptraumatol.springeropen.com/articles/10.1186/s10195-024-00812-z

the bikini incision direct anterior approach for total hip ... In Nairn et al.'s review, early DAA patients experienced an average complication rate of 20.8%, which dropped to 7.6% as surgeons became more ...

5. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0883540324005503

Vertical or Horizontal (Bikini) Incision for Direct Anterior ... Our study suggests that a horizontal bikini incision is less forgiving in the early postoperative period, if a more extensile exposure is needed for revision ...

6. arthroplastyjournal.org arthroplastyjournal.org/article/S0883-5403(24)00550-3/fulltext

Vertical or Horizontal (Bikini) Incision for Direct Anterior ... Our study suggests that a horizontal bikini incision is less forgiving in the early postoperative period if a more extensile exposure is needed for revision ...