Systems and methods for accessing an interior space of a joint such as a hip joint in preparation for arthroscopic surgery are provided. In general, the described techniques utilize a joint access device having a handle and a dilator shaft and/or sheath coupled to a distal end of the handle. The device can be advanced over a guidewire inserted into a joint to a first position and the guidewire can be reversibly locked to the handle. The handle can be associated with an actuator configured to be actuated to cause the dilator shaft and/or sheath to advance distally toward a second position within the joint while simultaneously retracting the guidewire coupled to the handle.