Evolution of Hip Arthroscopy in Modern Orthopedic Practice

Hip arthroscopy has evolved from early endoscopic concepts into a modern minimally invasive orthopedic surgical technique. This review examines the historical progression of hip arthroscopy, beginning with foundational developments in endoscopic visualization in the 19th and early 20th centuries and advancing through key milestones that enabled safe access to the hip joint. Early limitations related to joint anatomy and visualization were gradually overcome through innovations in traction techniques, portal placement, and instrumentation, facilitating the transition from a primarily diagnostic modality to a reliable therapeutic approach. The late 20th century marked a period of rapid advancement, with increasing recognition of intra-articular pathology such as acetabular labral tears and femoroacetabular impingement (FAI). These developments contributed to the expansion of hip arthroscopy as a commonly utilized method for addressing a wide range of intra-articular and extra-articular conditions. In the modern era, technological innovations, including high-definition imaging, miniaturized instrumentation, and needle-based arthroscopy systems, have enhanced surgeons' ability to diagnose and treat hip pathology while potentially improving procedural efficiency and safety. Emerging clinical evidence and contemporary surgical experience suggest favorable patient outcomes associated with these advances, although outcomes vary depending on patient selection, pathology, and surgical technique. Additionally, evolving surgical philosophies have emphasized joint preservation, with a shift toward labral repair and reconstruction, capsular management, and comprehensive treatment of underlying pathology. As indications continue to expand and techniques become increasingly refined, hip arthroscopy remains a dynamic and rapidly advancing field with significant implications for patient care and future orthopedic practice.