Audit reveals serious concerns over unnecessary hip surgeries in Dublin children’s hospitals.

A recently published audit into developmental dysplasia of the hip (DDH) surgeries performed on children in Dublin has revealed “grave concerns,” with a significant number of procedures at two major hospitals deemed clinically unnecessary. The report, commissioned by Children’s Health Ireland (CHI) and the National Orthopaedic Hospital, Cappagh (NOHC), highlights a concerning variation in surgical practice. It has led to calls to recall hundreds of children for independent review.

Extent of unnecessary hip surgeries across Dublin hospitals

The audit, which examined 147 cases of pelvic osteotomies performed between 2021 and 2023 across CHI Temple Street, the National Orthopaedic Hospital Cappagh, and CHI Crumlin, found stark differences in the application of surgical criteria. While 98% of procedures at CHI Crumlin met the agreed clinical indication, the figures were significantly lower at Temple Street and Cappagh, which used a lower threshold to decide on surgery.

This means that potentially hundreds of children have undergone invasive and traumatic surgeries they may not have needed. Specifically, the report indicates that almost 80% of procedures at NOHC and 60% at Temple Street did not meet the threshold for surgery within the audited timeframe. Overall, nearly 500 children who underwent pelvic osteotomy at these two hospitals between 2021 and 2023 have been recommended for recall and independent clinical and radiological assessment.

Serious concerns over clinical judgement and patient consent

The findings have raised profound questions about patient safety, informed consent, and the decision-making processes within the orthopaedic departments of these hospitals. Concerns were also highlighted regarding surgeries performed based on vague indications like “clicky hips” or “asymmetrical thigh creases,” and some children reportedly underwent surgery without prior non-surgical treatment. The audit also flagged using a “less invasive” technique that lacks long-term data, with parents not always being fully informed of its experimental nature.

HSE response and origins of the audit

The Health Service Executive (HSE) has acknowledged the variance as a “grave concern” and emphasised the need for a mechanism to prevent such discrepancies from recurring. The audit was initiated following a protected disclosure raising concerns about the thresholds applied for DDH surgery at CHI Temple Street and NOHC.

Mass recall and follow-up plan for affected families

In response to the report, a detailed plan is being developed to review approximately 1,800 children and young adults who have had this surgery at CHI Temple Street and NOHC since 2010. Letters have already been sent to over 1,800 families of children who received hip surgery over 15 years ago, inviting them for follow-up care.

Recommended changes to improve surgical oversight

Recommendations from the audit include the urgent recall and independent review of all affected cases, a standardised approach to multi-disciplinary team (MDT) assessments, and ongoing long-term follow-up for all children who undergo pelvic osteotomy surgery. A cross-site pre-operative surgical meeting has been implemented since March 2025 to ensure all children are discussed before being listed for surgery. An expert reference group, including international input, also develops criteria for future MDT assessments.

Next steps: safeguarding future patient care

The review’s findings emphasise the critical importance of rigorous clinical oversight, adherence to established guidelines, and transparent communication with families. The focus now turns to ensuring comprehensive follow-up for affected children and implementing robust measures to prevent the recurrence of such alarming surgical practices.

Further Information

At Coleman Legal LLP, we understand the trauma and distress that can come from medical negligence or paediatric negligence, especially when it affects children. Our experienced legal team is actively investigating the matter and is available to assist families who believe their child may have been affected due to unnecessary hip surgeries at Dublin Hospital. We can help you with:

• Reviewing medical records to identify if unnecessary hip surgeries occurred
• Accessing independent medical assessments
• Advising on your rights and potential legal claims
• Pursuing compensation for physical, emotional and financial harm

For further guidance, see our page on unnecessary hip surgeries on children. Call us at our freephone number 1800-844-104 or email us at [email protected]