The field of hip preservation has undergone rapid technological transformation, driven by innovations that enhance diagnostic accuracy, surgical precision, and personalized care. This review explores recent advancements and future directions in hip preservation surgery. The topics covered in this review include preoperative and intraoperative tools at the forefront of innovation, including three-dimensional (3D) modeling and templating, machine learning (ML), artificial intelligence (AI), virtual reality (VR), and robotic-, computer- and AI- assisted surgery. 3D modeling techniques, both static and dynamic, allow for comprehensive visualization of hip morphology and simulation of joint kinematics. These advancements enable precise identification of impingement and instability patterns. Patient-specific 3D printed models and surgical templates are currently used to enhance preoperative planning, patient and trainee education, and surgical efficiency. ML and AI applications have demonstrated utility for automating several processes including radiographic analysis, risk stratification, and outcome assessment. VR simulation tools facilitate immersive, patient-specific surgical planning and skill development. These tools allow surgeons to rehearse procedures in a risk-free environment. Computer-assisted navigation and AI-driven platforms augment this technology by providing real-time feedback and enhanced accuracy. Further, robotic systems are a promising tool for precise boney resection and instrumentation placement. These technologies are shaping the future of hip preservation by enabling more accurate diagnosis, personalized treatment, and improved surgical outcomes. Ongoing research in these areas is essential for validating clinical utility, improving accessibility, and ensuring safe and effective integration into clinical and surgical workflows.
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