Hip arthroscopy and the surgical drapes applied. The next step is to insert a fine needle under x-ray guidance into the hip joint. This breaks the 'suction seal' of the joint and allows further distraction if necessary (see fig 4). The surgeon wishes to see the ball move out the socket by approximately 1 cm, so that access to the hip joint can be achieved with minimal risk of damage to the joint surfaces. Most surgeons will inject fluid into the joint at this stage, again to ensure that there is enough space between the ball and socket for safe instrument access.
Hip dysplasia swaddling techniques, such as the 'hip healthy swaddle' have been developed to relieve stress on hip joints caused by traditional swaddling methods. Further risk factors include breech birth, gender, genetics (family history), and firstborns. In breech position the femoral head tends to get pushed out of the socket. A narrow uterus also facilitates hip joint dislocation during fetal development and birth. Most countries have standard newborn exams that include a hip joint exam screening for early detection of hip dysplasia. Sometimes during an exam a "click" or more precisely "clunk" in the hip may be detected (although not all clicks