Hip arthroscopy refers to the viewing of the interior of the acetabulofemoral (hip) joint through an arthroscope and the treatment of hip pathology through a minimally invasive approach. This technique is sometimes used to help in the treatment of various joint disorders has gained popularity because of the small incisions used and shorter recovery times when compared with conventional surgical techniques (sometimes referred to as "open surgery"). Hip arthroscopy was not feasible until recently, new technology in both the tools used and the ability to distract the hip joint has led to a recent surge in the ability to do hip arthroscopy and the popularity of it.


What is Arthroscopy
The idea of using a tubular viewing device in order to perform surgery is not new. Surgeons have been undertaking such procedures for more than one hundred years. However, some areas have proved harder than others when it comes to identifying a safe and suitable technique. The hip is most certainly one such area.
The problem has been the deep-seated nature of the hip joint and its ball-and-socket shape. One look at it is enough to agree with a Dr Burman who, in 1931, deemed hip arthroscopy impossible. However, the secret, if that is the correct word, is to understand that the hip joint is held together not only by its shape, muscles and ligaments, but also by suction.
Consequently, the hip arthroscopic surgeon will first of all pull on the leg (traction) with some form of specialist distractor in order to open up the hip a tiny amount. Once this first gap is made, it is possible to insert a needle into it and equalise the pressure inside the joint with atmospheric pressure. The moment that happens, so the hip opens up, just like magic! That is the principle, of course. Life is not always as easy as one might like, however, so gaining access to the interior of the hip joint can sometimes prove very difficult, even for the most experienced surgeons. Sometimes access is impossible.
Once the hip has opened up, an arthroscope is passed into it. This is approximately 5mm in diameter. A camera is attached to the end of the arthroscope and the image is displayed on a nearby screen. Surprisingly, it is uncommon for the surgeon to look at the patient very much at all during a hip arthroscopy. Most of the action is on the screen and it is there that the surgeon generally looks.
Once the arthroscope is in the joint, operating instruments are also inserted. These are not passed down the same portal of entry as the arthroscope but through adjacent portals. The operating instruments are of different designs but may be manual cutters, powered shavers and burrs, or radiofrequency probes. Radiofrequency is now widely used at hip arthroscopy. Lasers are less commonly used, although there was a period some years ago when laser hip arthroscopy was undertaken in a few specialist centres.
Arthroscopy is a surgical procedure that gives doctors a clear view of the inside of a joint. This helps them diagnose and treat joint problems.
During hip arthroscopy, your surgeon inserts a small camera, called an arthroscope, into your hip joint. The camera displays pictures on a television screen, and your surgeon uses these images to guide miniature surgical instruments.
Hip arthroscopy has been performed for many years, but is not as common as knee or shoulder arthroscopy.

Anatomy
The hip is a ball-and-socket joint. The socket is formed by the acetabulum, which is part of the large pelvis bone. The ball is the femoral head, which is the upper end of the femur (thighbone).
A slippery tissue called articular cartilage covers the surface of the ball and the socket. It creates a smooth, frictionless surface that helps the bones glide easily across each other.
The acetabulum is ringed by strong fibrocartilage called the labrum. The labrum forms a gasket around the socket.
The joint is surrounded by bands of tissue called ligaments. They form a capsule that holds the joint together. The undersurface of the capsule is lined by a thin membrane called the synovium. It produces synovial fluid that lubricates the hip joint.