JAAOS - 2026-08-27 - Journal Article
Extra-articular Hip Endoscopy: Current Indications, Evidence, and Techniques.
Goodwin D
Topics
Key Takeaway
Endoscopic management of greater trochanteric pain syndrome, iliopsoas tendinopathy, extra-articular impingement, and gluteal and hamstring tears yields reduced morbidity and faster recovery compared to open surgery, though outcome data remain largely level III-IV.
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Summary
This JAAOS review synthesizes current indications, surgical principles, and clinical outcomes for extra-articular hip endoscopy across four pathology domains: greater trochanteric pain syndrome, iliopsoas tendinopathy, extra-articular impingement, and gluteal and hamstring tears. The authors present endoscopic techniques as evidence-based alternatives to open surgery for active adults, emphasizing procedural pearls and pitfalls. No pooled quantitative outcomes or meta-analytic statistics are reported; conclusions are drawn from the existing literature base.
Key Limitation
As a narrative review without systematic search criteria or pooled outcome analysis, the evidence hierarchy for each individual endoscopic procedure is not formally graded, making it difficult to distinguish strong from weak indications across the four pathology domains.
Original Abstract
Advances in hip arthroscopy have expanded its use beyond intra-articular pathology to include a range of extra-articular conditions (endoscopy) that affect the active adult population. These minimally invasive procedures now provide practical, evidence-based alternatives to open surgery. Endoscopic techniques allow targeted management of greater trochanteric pain syndrome, iliopsoas tendinopathy, extra-articular hip impingement, and gluteal and hamstring tears with reduced morbidity and faster recovery. The purpose of this review is to summarize the current indications, key surgical principles, and clinical outcomes for extra-articular hip endoscopy, emphasizing pearls and pitfalls relevant to the practicing orthopaedic surgeon.