Benjamin Wilke MD

01/10/2026

Considering a total hip replacement? Understand your options before deciding on surgery.
Total hip replacement is a highly successful operation that relieves chronic pain and restores mobility for people suffering from severe hip arthritis. The procedure involves replacing the damaged hip joint with a durable artificial implant. One modern option is the bikini incision, a refined variation of the direct anterior approach. Instead of the usual straight vertical incision down the front of the thigh, the bikini incision is curved and angled to follow the natural skin fold or "bikini line" in the groin area, typically 4 to 6 inches long. This strategic placement makes the resulting scar much less noticeable, often hidden in everyday clothing, swimwear, or underwear.
The bikini incision delivers all the core advantages of the standard direct anterior approach while adding a significant aesthetic edge. Like the traditional anterior method, it accesses the hip joint from the front by working between muscle planes rather than cutting through major muscles (as happens in the posterior approach). This muscle-sparing technique generally leads to less postoperative pain, faster early recovery, quicker return of strength, and a lower lifetime risk of hip dislocation. Patients often walk sooner and face fewer movement restrictions. Multiple studies show that the bikini incision provides similar functional results and hip scores to the straight anterior incision, but with improved scar healing, reduced wound complications, and higher patient satisfaction regarding appearance.
In contrast, the posterior approach involves a curved incision on the back or side of the hip (usually 6 to 10 inches long). It works well for complex cases, but requires cutting and repairing the gluteal muscles, which can mean more initial discomfort, slower muscle recovery, and precautions against certain movements to prevent dislocation. While long-term results are comparable across all approaches, the bikini incision (and direct anterior techniques in general) often provides a smoother early journey with quicker rehab and better early mobility.
Not every patient is a candidate for the bikini incision; it can be more technically demanding and may not suit those with certain body types, severe deformities, or obesity. The standard direct anterior or posterior approach remains excellent choices depending on your specific situation. The key is choosing a surgeon experienced in the technique that best matches your needs. If you're considering hip replacement and want to explore the bikini incision for its potential for faster recovery and a more discreet scar, feel free to contact my office or schedule a consultation. Our team is here to help you understand your options and find the path that fits your lifestyle! Call us at (904) 204-5000, or book an appointment online at

Dr Benjamin Wilke is an orthopedic surgeon in Jacksonville, St. Johns County and Ponte Vedra Beach, Florida specializing in adult reconstruction and orthopedic oncology.

01/10/2026

Considering a total knee replacement? Take a few minutes and learn the different surgical approach options available to you.
Total knee replacement is a highly effective surgery that relieves severe knee pain and restores mobility for people with advanced arthritis. The procedure involves resurfacing the damaged ends of the thigh bone (femur) and shin bone (tibia) with metal and plastic components. A key factor in your recovery is the surgical approach. One advanced, muscle-sparing option is the subvastus approach, which minimizes trauma to the quadriceps (thigh) muscles compared to the traditional medial parapatellar approach. For patients eager to get back on their feet quickly, studies have shown that the subvastus method often provides a smoother and faster early recovery.
The subvastus approach is a quadriceps-sparing technique that preserves the full strength and integrity of the vastus medialis muscle (part of your quadriceps). Rather than cutting through the muscle or quadriceps tendon, these are gently lifted aside during the operation. This muscle-preserving approach leads to less postoperative pain, faster return of quadriceps strength (such as performing a straight-leg raise sooner), quicker improvement in knee range of motion, and often a shorter hospital stay. Multiple studies show patients experience earlier functional milestones, reduced need for pain medication in the first week, and better early knee flexion, helping you walk, climb stairs, and resume daily activities with greater confidence and less discomfort in the initial weeks after surgery.
In contrast, the medial parapatellar approach involves a straight incision along the front of the knee. The surgeon cuts through the quadriceps tendon to move the kneecap aside for clear access to the joint. While this provides excellent visibility and is highly reliable (especially for complex cases), it requires repairing the tendon afterward, which can result in more initial pain, slower quadriceps recovery, and a longer time to regain full leg strength. Long-term outcomes (such as pain relief and knee function) are very similar between the two approaches, but the subvastus method consistently delivers superior early results, often with patients achieving key mobility goals days or weeks sooner.
The subvastus approach is not ideal for every patient; it can be more technically challenging and may not suit those with severe knee deformities, significant obesity, or very stiff joints. The medial parapatellar remains an outstanding, proven option with excellent long-term results. The best choice depends on your unique anatomy, activity level, and overall health. If you are exploring total knee replacement and want to discuss the potential for a faster, less painful recovery with the muscle-sparing subvastus approach, feel free to contact our office or schedule a consultation today. We are here to
guide you toward the technique that aligns best with your goals and lifestyle! Contact us at (904) 204-5000, or book an appointment online at

Dr Benjamin Wilke is an orthopedic surgeon in Jacksonville, St. Johns County and Ponte Vedra Beach, Florida specializing in adult reconstruction and orthopedic oncology.

01/05/2026

Joint replacement is a significant step that can greatly improve your quality of life. Before deciding on hip or knee replacement surgery, take the time to explore all available options, including modern, less-invasive surgical techniques.

For hip replacement, ask about the direct anterior approach, which is muscle-sparing and often associated with a smaller incision, less postoperative pain, and a potentially faster recovery compared to traditional methods.

For knee replacement, inquire whether your surgeon uses the subvastus approach (a quadriceps-sparing technique) that can help preserve muscle strength, reduce early pain, and support quicker return to mobility.

It's also worth discussing whether your surgeon offers computer-navigated or robotic-assisted joint replacement. These advanced technologies can enhance precision in implant placement and alignment for potentially better long-term results.
Don't hesitate to seek a second opinion; it's completely normal and often very helpful when making such an important decision.

Feel free to ask your surgeon these specific questions. Being informed is one of the best ways to feel confident moving forward!