On Oct. 14, Barry Manilow rolled on stage in a wheelchair at Boardwalk Hall in Atlantic City, N.J., just seven weeks after becoming one of the thousands of Americans who undergo hip surgery each year. With his backup singers dressed as nurses, Mr. Manilow then jumped up to sing, "It's a Miracle."

"I'm standing," the 63-year-old performer told the packed auditorium, adding he was feeling a little "wobbly."

It could have been worse. After 30 years of shows performing his 1970s hit, "Copacabana," Mr. Manilow faced the prospect of having both hips replaced this past summer. The operation would have likely left him seated at the piano during concerts. Instead, he underwent hip arthroscopy, a newer less-invasive procedure that repairs the hip rather than replacing it with an implant.

Patients are candidates for hip arthroscopy if arthritis hasn't set in around the hip joints -- the head of the femur, or the ball; and the acetabulum, or socket. Patients with arthritis, where the cartilage has started to deteriorate, will likely need a hip replacement at some point. The most common reason to have arthroscopic surgery is a tear in the labrum, a lining around the rim of the cartilage that covers the socket and acts as a cushion. Labral tears can occur over time from wear and tear, or from an accident, says Carlos Guanche, the Southern California orthopedic surgeon who performed Mr. Manilow's surgery.

With arthroscopy, the surgeon inserts a narrow camera and a tool to repair the labrum through two tiny incisions either in the groin area or along the side of the hip. Replacing the hip typically calls for an incision anywhere from 4 to 8 inches. The arthroscopic operation, which insurers will cover, takes as little as an hour in some cases; it usually has shorter recovery time.

About 15,000 hip arthroscopic surgeries are performed each year, compared with more than 200,000 hip replacements. The typical patient is younger and athletic. Los Angeles Kings hockey star Aaron Miller had hip arthroscopic surgery in April and has played eight games so far this season. "My hip feels great," says 35-year-old Mr. Miller, who has played hockey for 30 years. He adds that it also helped alleviate long-standing back pain.

Arthroscopic surgery has been done for years on shoulders and knees but the hip procedure started to take off in the past five years with the development of new techniques and instruments to diagnosis and treat torn labrums, says orthopedic surgeon Joseph McCarthy, who was one of the pioneers of the procedure in the 1980s. He says surgeons also had to be trained to diagnose and repair the labral tears, which are hard to detect because the ball and socket are hidden.

Dr. McCarthy says hip arthroscopies aren't widely done, in part, because physicians advise patients against it, believing the torn labrum would heal itself. But studies show that patients who didn't get their labrum repaired had arthritis set in, says Dr. McCarthy, vice chairman of program development for Massachusetts General Hospital's orthopedic surgery department.

A tear in the labrum causes friction against the cartilage, leading to erosion of the cartilage. To repair the tear, surgeons either clip away the torn piece or suture the labrum to the bone. Labrum tears also regularly go undetected by general physicians and orthopedic surgeons, says Lawrence Dorr, a Los Angeles hip specialist who diagnosed Mr. Manilow. Patients "get ignored because nobody can figure out what's wrong," Dr. Dorr says.

Over the past four years, Mr. Manilow saw several physicians, including orthopedic surgeons, and underwent screening to find out why he was in such pain, he says. His X-rays showed no arthritis but physicians told him they thought he would eventually have to have his hips replaced, Mr. Manilow says.

Meanwhile, Mr. Manilow says, he was on increasingly heavier doses of pain pills to get through his 90-minute performances five nights a week in Las Vegas.

In June, he saw Dr. Dorr, who tested the singer's range of motion. Noting that Mr. Manilow still had some key movement, Dr. Dorr sent Mr. Manilow for a specialized MRI screening where a contrast agent is injected into the hips and highlights the cartilage. The pictures further confirmed that Mr. Manilow had torn labrums in both hips.

On Aug. 28, the day after winning an Emmy, Mr. Manilow had the operation under general anesthesia. It took one hour; Mr. Manilow went home that same day.

By the fourth week after extensive physical therapy and using some pain killers, Mr. Manilow was rehearsing 12 hours a day, preparing his return to the Las Vegas Hilton and his coming tour for his new album covering '60s songs. "Historically that never would have happened," referring to the rehearsal, says Dr. Guanche. "If you did one hip replacement, he would have never been up there."

Mr. Manilow notes he won't be doing spins on stage for a while. At his Atlantic City show, he walked down a stairway during his big finale, "Copacabana." "Give me a month, and I'll be running down that stairway," he says.