Hip Dysplasia Claims*

Hip dysplasia, also known as Developmental Dysplasia of the Hip (DDH), is a condition in which the hip joint does not develop properly. In a healthy hip, the ball at the top of the thigh bone (the femoral head) fits securely into the cup-shaped socket of the pelvis (the acetabulum). In children with DDH, the socket may be too shallow, causing the joint to be loose, unstable or, in more serious cases, partially or fully dislocated.

DDH is a congenital condition, meaning it is present at or around the time of birth. It can affect one or both hips but is more common on the left side. The condition ranges in severity from mild instability to complete dislocation, and the long-term impact depends heavily on how early it is detected and treated.

If diagnosed early, DDH can usually be managed with simple, non-invasive treatments such as a Pavlik harness. If it is missed or treated too late, the consequences can be significant, including the need for invasive surgery, chronic pain, premature arthritis and eventual hip replacement.

While the exact cause of DDH is not fully understood, several factors are known to increase a child’s likelihood of being born with the condition.

Family history is one of the strongest indicators. A child with a parent or sibling who had DDH is roughly five times more likely to develop the condition. Gender also plays a role; approximately 8 in 10 cases occur in girls, likely due to the effects of oestrogen on ligament flexibility during development.

Breech positioning (where the baby’s feet or bottom are facing downwards after 28 weeks of pregnancy) significantly increases risk. Breech babies delivered by caesarean section have a risk roughly seven times higher than average, while those delivered vaginally have a risk approximately 17 times higher. First-born children account for around 6 in 10 DDH cases, possibly because the uterus is tighter and allows less movement during a first pregnancy.

Other contributing factors include low amniotic fluid levels (oligohydramnios), premature birth, high birth weight (over 5kg), and the presence of other neuromuscular conditions such as cerebral palsy or spinal cord problems.

Understanding these risk factors matters in a legal context because healthcare professionals are expected to flag high-risk babies for closer monitoring and follow-up screening.

In Ireland, all newborn babies undergo screening for DDH within the first 72 hours of life. This involves a physical examination in which the baby is laid flat and the hips are gently moved through a range of positions. A distinctive “clunk” sound during this examination may indicate that the hip joint is unstable or out of place, and should prompt an urgent referral for an ultrasound scan to confirm the diagnosis.

Follow-up checks are also carried out by GPs at around 6 to 8 weeks, and by public health nurses at developmental checks between 8 and 9 months and again at 2 years.

Ultrasound is the primary diagnostic imaging tool for infants under 6 months, as their bones have not yet fully hardened. For older children, pelvic X-rays are used to monitor hip development over time.

Early detection is critical. When DDH is identified in the first few weeks of life, the success rate of conservative treatment is very high. When diagnosis is delayed beyond the first few months, treatment becomes more complex, more invasive and less likely to achieve a fully normal hip.

The approach to treating DDH depends on the child’s age at diagnosis and the severity of the condition.

The long-term consequences of untreated or poorly treated DDH can be severe and life-altering.

Children whose hip dysplasia is missed in infancy often develop an abnormal gait, including limping or waddling. They may experience chronic hip pain from a young age, along with restricted movement and leg length differences. Many will develop early-onset osteoarthritis, sometimes requiring hip replacement surgery as early as their 40s.

Approximately 3 in 10 hip replacement operations performed on people under the age of 60 are linked to DDH that was either untreated, unsuccessfully treated or diagnosed too late. The impact extends beyond physical health; children who undergo multiple surgeries face extended hospital stays, disrupted schooling, emotional distress and reduced participation in sport and social activities.

For families, the financial burden can also be significant, with costs for ongoing medical care, physiotherapy, mobility aids and home modifications accumulating over many years.

Medical negligence in the context of DDH can occur at several stages of a child’s care.

In 2023, a clinical audit was launched into hip dysplasia surgeries performed on children at two Dublin hospitals: Temple Street (CHI) and Cappagh (NOHC). Concerns had been raised by whistleblowers about whether hundreds of children had been subjected to invasive and unnecessary surgical procedures.

A draft report from the audit indicated that the surgical threshold applied at these hospitals was significantly lower than international standards. The investigation has since been extended to cover a period stretching back approximately 15 years, with families now receiving letters about operations carried out on children who are, in some cases, now adults.

The scope of the review has expanded, and an external expert panel involving specialists from multiple countries has been appointed to examine the cases. The full report has not yet been published, and many families are still waiting for clarity about whether their child’s surgery was among those flagged.

If you have received a letter from CHI, or if you have concerns about hip surgery your child underwent at Temple Street or Cappagh, it is important to seek independent legal advice as soon as possible. Crimmins Howard can help you understand your options and take the appropriate steps to protect your child’s rights.

Compensation in a hip dysplasia claim is assessed under two main categories.

General damages cover the pain, suffering and loss of quality of life experienced by the child. This includes the impact of surgery, recovery periods, restriction of activities, emotional distress and the long-term prognosis for their hip health.

Special damages cover the financial losses and expenses arising from the negligence, broken down into past and future costs. These may include:

• Medical and surgical expenses (past and future)
• Physiotherapy and rehabilitation costs
• Parental loss of earnings due to caregiving responsibilities
• Nursing or home care
• Cost of mobility aids or equipment
• Home and transport adaptations
• Future loss of earning capacity for the child

Compensation is assessed with reference to the Personal Injuries Guidelines, and the amount awarded will reflect the specific circumstances and severity of each case.

Time Limits for Hip Dysplasia Claims

Under the Statute of Limitations, the standard time limit for medical negligence claims in Ireland is two years from the date of knowledge. This is the point at which you became aware, or ought reasonably to have become aware, that the injury may have resulted from substandard medical care.

For children, the limitation period does not begin until the child’s 18th birthday. This means a claim can be brought at any time up to their 20th birthday. However, a parent or legal guardian can (and should) act on the child’s behalf well before that date. Early action ensures that medical records are preserved, evidence is fresh and the strongest possible case can be built.

These time limits are strictly enforced. If you have any doubt about whether you are still within time, contact us as soon as possible for clarification.