To evaluate and compare the early clinical results between bikini incision for anterior approach and orthop?dische chirurgie München (OCM)approach for total hip arthropasty.

Eighty patients (80 hips) with avascular necrosis of the femoral head who underwent total hip arthroplasty for the first time from September 2016 to September 2017 in the Joint Surgery Department of the Affiliated Hospital of Qingdao University were retrospectively selected. Patients diagnosed as rheumatoid arthritis, congenital dysplasia or dislocation of the hip and previous history of hip surgery were excluded. Among them, 30 coses underwent Bikini incision for direct anterior approech (DAA) and 30 cases underwent OCM. There were 47 males and 33 females with an average age of (66±10) years. The general data, operation time, intraoperative bleeding volume, postoperative drainage volume, hemoglobin content, postoperative blood transfusion rate, incision length, limb unequal length incidence, hospitalization days, perioperative Harris score and visual analogue scale (VAS) score, quadriceps femoris and abductor hip muscle strength recovery time, amount of CK and CRP in serum, imaging findings and surgical complications were analyzed to evaluate the perioperative effects of the two surgical methods.

A total of 80 patients were followed up for an average of (6.5±2.3) months. Compared with OCM group, Bikini group had shorter recovery time of abductor muscle strength and less changes of serum CK and CRP. However, there was no significant difference in general information, operative time, intraoperative blood loss, postoperative drainage, hemoglobin content, postoperative blood transfusion rate, incision length, limb unequal length, hospitalization time, perioperative Harris score, VAS, quadriceps femoris muscle strength recovery time or imaging findings between the two groups. But Bikini approach and OCM approach had significant differences in operative time, intraoperative bleeding volume, postoperative drainage, acetabular anteversion and abduction angle between the first 10 patients and the latter 30 patients (all P<0.01).

Bikini approach and OCM approach can achieve good short-term clinical results. Bikini approach has less muscle damage, weak inflammatory response, abductor muscle strength recovery is fast. There is a learning curve in the two operative approaches.