ReviewHealth science reports2026
Oblique Bikini Incision Versus Longitudinal Incision for Direct Anterior Approach Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.
Review in Health science reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Aims: Standard protocols for the direct anterior approach (DAA) typically employ a longitudinal incision, which violates Langer's lines and may compromise scar esthetics. The oblique "bikini" incision aims to improve cosmesis by following natural skin tension lines, but it raises anatomical concerns regarding iatrogenic lateral femoral cutaneous nerve (LFCN) injury. This study aimed to systematically evaluate the safety, functional, and esthetic outcomes of the bikini incision versus the traditional longitudinal incision in DAA total hip arthroplasty (THA). Methods: Adhering to the PRISMA 2020 guidelines, we searched major databases for comparative studies (both randomized controlled trials (RCTs) and observational cohorts) of bikini versus longitudinal incisions in DAA-THA. Primary outcomes were scar cosmesis and LFCN injury incidence. Secondary outcomes included operative time and wound complications. Data were pooled using a random-effects model, and subgroup analyses were performed to explore heterogeneity based on study design. Results: Eight studies comprising 2017 hips were included. The bikini incision demonstrated significantly superior scar cosmesis (SMD = -0.62; 95% CI [-1.00, -0.24]; Conclusion: The bikini incision offers superior scar esthetics without prolonging operative time and demonstrates a potential trend toward minimizing wound complications. However, surgeons must remain vigilant regarding LFCN anatomy, as rigorous RCTs suggest a higher anatomical risk of nerve injury. This approach is recommended primarily for experienced surgeons who have surpassed the standard DAA learning curve.
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