DUBLIN, Ireland: Nearly 500 children who had hip surgery at two Dublin hospitals between 2021 and 2023 may need to be recalled for review following a clinical audit that revealed many of the procedures did not meet the standard threshold for surgery.

The final report, published by Children's Health Ireland (CHI) and the National Orthopaedic Hospital Cappagh (NOHC) this week, found that Temple Street and Cappagh hospitals had used a lower threshold for operating on children with developmental dysplasia of the hip (DDH), leading to what the report described as "unnecessary" surgeries in many cases.

According to the audit, 497 children underwent pelvic osteotomy procedures during this period. The report recommends all of these cases now be recalled for an independent clinical and radiological review.

The audit found that 60 percent of surgeries at Temple Street and almost 80 percent at Cappagh did not meet the established clinical criteria. Specifically, 51 of the 85 surgeries reviewed at Temple Street failed to meet the criteria; at Cappagh, 55 of 70 surgeries did not qualify.

Each of these cases is to be reviewed by experienced pediatric orthopedic surgeons from institutions not involved in the original procedures. Further follow-up with independent clinicians may also be required.

The report examined 147 DDH cases across CHI sites, including Crumlin, and involved 14 surgeons. It noted inconsistencies in how the surgical threshold was applied across different hospitals.

Children's Health Ireland CEO Lucy Nugent issued an apology to the affected families, acknowledging the distress caused. "We are currently standardizing care across all CHI sites so all children receive the same high-quality treatment no matter where they are seen," she said. "We must now act swiftly to review these cases."

Angela Lee, CEO of NOHC, also apologized, saying, "We are committed to implementing the audit recommendations. Some changes are already underway, with others planned."

Families of affected patients will be contacted directly and provided with follow-up plans. The audit's findings come amid ongoing efforts to reform and improve pediatric orthopedic services across Ireland.

Minister for Health Jennifer Carroll McNeill acknowledged the emotional toll the report would have on families. "My immediate priority is to ensure there is clinical follow-up and care for these children, in line with best practice," she said.