Dr. Robert Sershon

04/25/2025

✨ What is a Bikini Incision Anterior Hip Replacement—and Why Are Patients Loving It? ✨

If you're considering hip replacement, you may have heard about the bikini incision anterior approach—a minimally invasive technique that’s gaining attention for its cosmetic and recovery benefits.

🔹 Smaller, more hidden incision – The incision follows the natural skin crease in the groin, which often means a less visible scar). See the below images of a patient only 3 weeks out from surgery.

🔹 Muscle-sparing – The anterior approach avoids cutting major muscles, which can lead to faster recovery, less pain, and quicker return to activity.

🔹 Lower dislocation risk – Because we go between muscles rather than through them, the hip joint remains more stable after surgery.

🔹 Quicker return to life – patients walk the same day, return home only hours after surgery, and are soon on their feet and moving with confidence.

This isn’t just about a smaller scar—it’s about getting you back to doing what you love, with less interruption and more confidence.

Schedule with Dr. Sershon to see you're a candidate for a bikini incision hip replacement.

https://andersonclinic.com/providers/robert-sershon-md/



Anderson Orthopaedic Clinic

10/30/2022

04/02/2022

is back due to popular demand!

65 year old referred to me for further management of a proximal tibia fracture with nonunion and aseptic tibial loosening. He has been wheelchair bound due to post-polio on his left leg. He walked independently prior to this fracture.

Difficult case given the involvement of the tibial tubercle. Tibial tray removal could result in a complete dissociation of the proximal tibial with extensor mechanism. In this case, we used the plate to our advantage, leaving it in place while removing the tibia. We then removed the plate and prepped for the cone and bypassing stem. He was made WBAT and kept in an immobilizer for 4 weeks, then allowed progressive ROM.

At 3 months post-op, he has regained his ability to ambulate and has regained full ROM. Functional scores are improved, and his tubercle remains stable.

Other ways to handle this?

03/07/2022

Most joint replacement surgeons were told their services were considered “non-essential” at some point during the pandemic.

A controversial topic, the op-ed below addresses how outpatient surgery for joint replacements has proven a safe and valuable means of treating patients during uncertain times.

https://www.medpagetoday.com/opinion/second-opinions/97516

Outpatient surgery can be a safe and effective route for many orthopedic procedures

11/29/2021

We are excited to host the 2021 Hip Society Rothman-Ranawat Traveling Fellows! Below is a case we were able to discuss and then complete in my OR today.

75 year old with left hip pain following a fall with acute inferior p***c ramus fracture in the setting of a chronically loose acetabular component. CT showed no posterior injury with Paprosky 2C defect. Titanium ions were elevated with Cobalt and Chromium under 2.

A posterior approach was utilized. The recalled modular stem was removed without an osteotomy. This facilitated acetabular exposure. The distal body of the modular stem was used to decreased bleeding from the canal during cup preparation.

The cup was 40 degrees retroverted, had a broken screw, and contained an alumina ceramic liner. It is imperative to not fracture the ceramic liner during removal. After cup removal, a metal cutting burr was used to address the broken screw remnant.

A peripheral rim fit was able to be achieved. Following debridement, crushed cancellous allograft was reversed reamed into the medial defect. A multi-hole cup was inserted with excellent press-fit. Intraoperative XR with trials was used prior to screw placement. The final components were then implanted.

Post-op she will be toe-touch weight bearing for 6 weeks, placed on Vit D, and received 1 week of oral antibiotics.

We’re looking forward to a great visit and listening to their talks tomorrow.

07/09/2021

75-year old transferred to my care for recurrent anterior dislocations (x4) within 3 weeks following a head and liner exchange for polyethylene wear.

The previous surgeon cemented a liner into the shell for increased head size and offset. This is an acceptable means of treatment. Unfortunately, the liner was excessively anteverted.

We returned to the OR for a revision THA utilizing an anterior approach. Given the multiple dislocations and neutral cup position, I elected to revise the cup rather than cement a liner. I believe either option was acceptable.

A standard anterior approach was utilized, extending slightly more distal for improved acetabular visualization. The posterior capsule is elevated and the neck/trunnion will fall out of the way, which creates excellent cup exposure.

Fluoroscopy is a valuable tool during anterior hip revisions. This allows the surgeon to easily evaluate cup preparation, final cup position, and screw trajectory. In this case, I performed minimal medialization to maintain offset. Further, her arthritic spine pushed me to use a dual mobility construct. An offset liner with 36mm head may have also been an appropriate choice here.

Postoperatively, she was kept partial weight-bearing for 6 weeks with anterior + posterior precautions. Following this, all precautions were lifted. They have returned to work, are ambulating device free, and report no pain.

05/14/2021

This week on

This is a 75 year old with left hip replacement performed in 1993 that was involved in a low speed car accident. They sustained a fracture through a large osteolytic lesion, resulting a loose acetabular component with significant superior-lateral, ischial and posterior acetabular defects.

An acetabular revision was performed. The cup was removed by hand and the osteolytic lesions were debrided. The remaining bone stock consisted of the anterior-superior dome and 1/3 of the width of the posterior-inferior ischium. Using a reverse reaming technique to conserve bone, a press-fit was able to be achieved with an TM revision shell. The shell was placed in a vertical and retroverted position to enhance the press fit and optimize screw purchase into the remaining ischium. A dual mobility polar cup was cemented into this shell at the desired anteversion and inclination.

Postoperatively, the patient was kept partial weight-bearing for 6 weeks, followed by a progressive increase in activity. They are currently doing well, walking without assistive device and living independently.

04/23/2021

64 year old with a displaced femoral neck fracture in the setting of a loose distal femoral replacement extending to the lesser trochanter. There is not enough space for a THA/hemi, and ORIF is a suboptimal option for this fracture. What to do? Total femur it is!

She was treated with an intramedullary total femoral replacement using the OSS system. We chose to use an IM femur to preserve the soft tissue attachments to the remaining femur (specifically the abductors).

We positioned the patient laterally on a Jackson table for fluoro use. A posterior approach to the hip was performed first. Following removal of the head and prep of the acetabulum, we moved on to the knee. The femur was grossly loose. Following cement/implant removal, we reamed the canal and then began trialing.  

Trialing is challenging. Introducing the implant through the knee, we trialed multiple proximal bodies. Axial pressure must be applied through the knee during trialing, or else the trial will shoot out distally. I also approximated the knee arthrotomy with towel clips to keep the patella reduced while assessing femoral anteversion/length/offset. Once the hip is reduced, both hip stability and knee stability are assessed simultaneously. When in doubt…lengthen. A shoe lift is better than current dislocations.

When implanting, we linked the hinge at the knee first. This allowed us to trial at the hip a final time and move the leg as a single unit. Then the proximal body was placed.

Postoperatively, the patient was allowed to be WBAT with a walker and hip precautions. Now 6 months out from surgery, this patient is ambulating with a cane, has avoided early complications, and is back living independently.

04/17/2021

This is a 64 year old transferred for care of their infected hip with periprosthetic fracture. These are difficult cases, as the body is fighting both infection and attempting to heal a fracture.

The prior posterior approach was used. The stem, cement, and cables were removed, followed by a thorough debridement. The anterior and posterior walls were largely deficient. To span the fracture, a long hemi-head spacer was inserted. After 3 months, the incision was healed, labs nearly normalized, and hip aspiration was negative.

The patient underwent a reimplant with a G7 cup and Arcos stem. The cup was sized to maximize anterior-superior and posterior-inferior buttress fit. The stem spanned the fracture. Cables were swapped again to decrease biofilm burden.

Post-op, the patient initially did well but underwent an I&D for recurrent infection at 6 weeks with a different organism. Given continued drainage, a repeat I&D was performed at 7 weeks. A PICC line then suppressive antibiotics were used.

The patient is now 6 months out, pain-free without a cane, and walking miles daily. He will continue antibiotics indefinitely.

03/26/2021

On this week’s

76 year old patient transferred with a large anterior capsular defect and completely deficient extensor mechanism in the setting of an infection.

These cases are extremely challenging and are (in my opinion) considered limb salvage procedures. A thorough debridement is required, oftentimes with 1-2 return visits to the OR to reduce the bacteria burden.

Given the defect size, a gastroc flap was required immediately following the explant with static spacer. This made the option of an Achilles autograft/flap less appealing for a future reconstruction. Thus, I decided to pursue an EM reco with mesh during the second stage. A LCCK with cone was used. While cementing the tibia, the mesh can be tucked into the mantle for fixation. The mesh can then be incorporated proximally.

The patient was placed in a cast for 10 weeks and then allowed progressive ROM/strengthening. She is currently 6 months out from surgery, has avoided an amputation and/or recurrent infection, and is ambulating with an assistive device.

03/19/2021

This week’s

74 year old with a 15 year old partial knee replacement and worsening pain. She had done very well until 2 years ago. We performed a revision knee replacement for lateral compartment arthritis.

Given her valgus alignment, it is possible she was “over-corrected” into valgus at the time of her initial replacement. Our research at has shown over-correcting results in higher rates of revisions for lateral arthritis.

Oftentimes, partial knees can be converted to total knees without the need for augments or stems. I prefer to place a small stem on the tibia in all cases and use a CR femoral component with congruent poly when femoral bone stock allows.

Leaving the femoral component in place for the distal femoral cut is a nice trick to re-create a native knee scenario. Once the pegs are encountered, remove the femur and finish the cut.

For the tibia, measure the cut off the lateral side. This will often result in a medial sided defect, which can be addressed with autograft from the lateral plateau cut or augments. In this case, there was a medial lytic lesion requiring an augment.

Post-op, I allow immediate mobilization and follow our primary knee rehab protocol. In many cases, a primary knee outcome is achievable. However, I always caution patients that revisions can be unpredictable.

At 4 weeks out, this patient is free of a cane, taking only Tylenol, and has ROM 0-121 degrees.

03/15/2021

Our experience at The Anderson Orthopaedic Clinic since 2007 has demonstrated a low risk of periprosthetic fractures (< 1%) within 90 days of surgery - regardless of the approach used.

Collared stems and fit-and-fill stem designs have resulted in the lowest fracture risk. Advanced age and female s*x resulted in higher fracture risk.

Check out our newest publication in the Journal of Arthroplasty.

https://authors.elsevier.com/c/1ckmz38vD2~b~i