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Introduction: The direct anterior approach (DAA) for hip arthroplasty has gained popularity in recent years with numerous articles suggesting that short-term outcomes are advantageous over alternative approaches. The ‘bikini’ inguinal crease line incision is a novel variant of the DAA, which reduces the scar. Methods: We conducted a retrospective cohort study to assess functional and general health outcomes and complications of the two different surgical incisions used in DAA total hip arthroplasty (i.e. ‘bikini’ and longitudinal incisions). Results: We found no statistical difference between the novel bikini incision and the traditional DAA hip arthroplasty. Conclusion: This approach offers a cosmetically improved scar with no compromise in outcomes.

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To establish the healthcare factors that contribute to testicular torsion adverse events (orchidectomies) and 'near misses'. The secondary objective was to identify areas suitable for impactful quality improvement initiatives to be undertaken by National Health Service (NHS) healthcare providers nationally. Materials and MethodsThis was a retrospective record review and analysis, carried out in four phases. We applied the well-validated London Protocol patient safety incident analysis framework to all eligible serious incidents related to testicular torsion submitted by English NHS Trusts over a 12-year period to the Strategic Executive Information System database. Clinical reviewers established the incident population (Phase 1), were trained and piloted the feasibility of using the London Protocol (Phase 2), applied the protocol and themed the identified contributing factors linked to adverse events (orchidectomies) and nearmisses (Phase 3), and reviewed the evidence for improvement interventions (Phase 4).

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