SPAIRE vs BIKINI

The SPAIRE (Spare Piriformis And Internus, Repair Externus) and Bikini Hip Replacement techniques are both innovative approaches within the realm of hip arthroplasty, each with its unique set of advantages. Here's a detailed comparison based on the information retrieved:

Incision and Surgical Approach

• SPAIRE Technique:

  • This technique employs a muscle-sparing mini-posterior approach, which is aimed at minimizing tendon and muscle damage around the hip joint. The key feature of SPAIRE is that it only requires the division and subsequent repair of the obturator externus tendon, while sparing other key tendons and muscles around the hip, like the piriformis, superior gemellus, and obturator internus. This approach is designed to maintain the natural anatomy and biomechanics of the hip to a large extent, facilitating a quicker recovery and better functional outcomes​.

• Bikini Hip Replacement:

  • The Bikini Hip Replacement utilizes a minimally invasive anterior approach. The incision is made along the bikini line, thus earning its name. This technique is an evolution of Hueter's minimally invasive anterior approach and is designed to fit a total hip replacement while preserving the surrounding anatomical structures. Unlike traditional anterior approaches, the Bikini incision avoids musculotendinous section, which helps in reducing the recovery time and the risk of dislocation of the prosthesis​.

Recovery and Post-operative Outcomes

• SPAIRE Hip Replacement:

  • Patients tend to experience a quicker recovery with fewer complications due to lesser tendon injury. The technique leaves the major tendons around the hip intact, which is significant for reducing post-operative pain and accelerating the rehabilitation process​.

• Bikini Hip Replacement:

  • Patients also tend to have a faster recovery with this technique due to the preservation of musculotendinous structures. The risk of prosthesis dislocation is reduced, and the aesthetic outcome of a less visible scar is often appreciated by patients​.

Aesthetic Consideration

• SPAIRE Technique:

  • The SPAIRE technique does not have a specific aesthetic focus as its primary aim is to spare muscle and tendon structures, thus improving functional outcomes and speeding up recovery.

• Bikini Hip Replacement:

  • The aesthetic outcome is one of the significant advantages of the Bikini Hip Replacement technique. The incision along the bikini line results in a scar that is easily concealed, which can be a significant factor for patients concerned about post-operative scarring​.

Conclusion:

Both the SPAIRE and Bikini Hip Replacement techniques are advancements that reflect a patient-centric approach in orthopaedic surgery, focusing on minimizing tissue damage, accelerating recovery, and in the case of the Bikini technique, improving aesthetic outcomes. The choice between the two may depend on various factors including the specific anatomical, functional, and aesthetic concerns of the patient, as well as the surgeon's expertise with either technique.