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Anterior Approach Cosmetic Incision

The anterior approach has gained increasing popularity because it may compromise less of the hip’s stabilizing tendons and ligaments than other approaches. In appropriate cases it may allow for an earlier return to regular activities. The approach is between two muscles at the front of the thigh. It does not cut any muscles or tendons. Other approaches may require a period of protection to prevent dislocation before return to regular activities.

Anterior vs Mini Posterior

Nerve Damage Possible Common Risks < 1%

  • Anterior: possible injury to a small nerve supplying sensation to part of the upper thigh
  • Posterior: greater chance of injury to the sciatic nerve

Blood Loss

  • Anterior slightly greater


  • Less common with Anterior

Hospital Stay and Return to Activities

  • Shorter downtime with Anterior

How Do I Choose

Choose Your Surgeon First

  • The results may be the same no matter the approach.
  • Many good surgeons are experienced in a number of approaches.
  • The approach may depend on a number of factors including your health, weight, and the anatomy of your hip.
  • Work with a physician who can explain your situation, has the experience to address it and the skills to perform a number of different approaches. Above all the doctor must inspire your confidence and trust.

Anterior Total Hip Replacement with the Skin Crease Bikini Incision

A Cosmetic Incision in Natural Skin Lines

The body has skin lines and creases that are natural. Plastic surgeons often use these lines and creases to hide their incisions making the evidence of their work less visible. Orthopedic surgery often crosses these lines allowing for better exposure of the bone or joint, but leaving highly visible scars. The usual anterior approach total hip incision is a longitudinal line going down the front of the thigh often as much as five inches long and five to ten inches from the groin. It is not designed for cosmesis.

The Anterior Skin Crease Bikini Incision

This incision takes advantage of the natural crease present at the top of the thigh and directly over the hip joint. This crease is visible when the hip is flexed. An incision buried in this crease is far less visible than other hip incisions. Concerns about visualizing the bone and deep tissues around the hip may limit this approach to patients in whom deep visualization is not an issue.

Anterior Approach Cosmetic Incision