Abstract
The direct anterior approach (DAA) to the hip has gained popularity with many potential early outcomes benefits for primary total hip arthroplasty (THA). The bikini type oblique incision has been proposed to help with the cosmetic appearance of the scar in conjunction with this approach. In this article, we describe the surgical technique of performing a DAA using a bikini incision. The important keys to the acetabular and femoral preparation and exposure during this technique are retractor placement and use of offset instruments when needed to ensure safe preparation and satisfactory seating of the final implants. The preliminary results of the bikini type incision is promising and offer all of the benefits of the DAA for primary THA, with additional advantage of an improved cosmetic appearance of the surgical scar.