How knee replacement affects the planet

A complete knee replacement can significantly improve a patient’s quality of life, but the procedure itself first It will create approximately 30 pounds of wasteabout half are biohazardous and require energy-intensive treatment for safe disposal.

Cataract surgery can give clear vision, but only then Emission equivalent to 181.8 kg of carbon dioxidealmost like a car that goes 315 miles.

Although healthcare is one of the largest sectors in the United States, its environmental impacts tend to fly under the radar: they account for 10 percent of the nation’s greenhouse gas emissions, and operating rooms generate 20-33 percent of total hospital waste. Researchers are just beginning to track and understand the sector’s environmental impacts.

Among those researchers is a team from the University of Pittsburgh whose work outlines the effects of health care on the environment, in this case focusing specifically on a waste-intensive and energy-intensive specialty: orthopedics. Researchers from Beth School of Medicine and Swanson College of Engineering reviewed the existing literature and found that while data is still sparse, efforts to reduce orthopedic’s carbon footprint can have a significant impact.

“Surgical suites have a significant environmental impact, in part because many of the items they rely on are single-use, disposable products, such as gowns, gloves, surgical instruments, and packaging,” explained co-author Melissa Belk, co-director of the Mascaro Center. for Sustainable Innovation and the William Kepler Whitford Professor of Civil and Environmental Engineering. “We are just beginning to discover the effects of the field, but we know the effects are there. We also know that more research is needed to really identify best practices for reducing environmental impacts and climate change and working toward a circular economy.”

The circular economy focuses on reusing items and materials to keep them in circulation rather than putting them in a landfill at the end of their life cycle. Bilec Lead an NSF-funded project Which brings together a five-university, multidisciplinary team to leverage convergence research to tackle the complex challenge of global waste and create a circular economy.

UPMC Sports Medicine Fellows and co-authors Ian Engler and Andrew Curley were inspired to join this project upon realizing the role their discipline plays in climate change — and how little the literature addresses it.

“While thousands of articles are published in the field of orthopedics each year, very few of them address the topic of sustainability,” Engler said. “Given the huge impact of climate change, we believe that every area must consider its role in becoming more sustainable.”

“We wrote this review paper to help the orthopedic field engage in learning about and minimizing our impact on the planet,” Curley added.

In this review paper, researchers reviewed studies that evaluated the impact of surgical procedures by completing a baseline waste audit, in which all waste is collected, sorted and weighed, or a more complex Life Cycle Assessment (LCA), which quantifies the overall environmental impact of the resources used.

Some of the current interventions in orthopedics include the use of low-emissions manufacturing and anesthesia techniques, redesigning custom packaging, reducing single-use devices and materials, reducing equipment in trays, and proper waste separation and recycling.

These changes can make a big difference. For example, the authors note that widespread hand surgery has recently become popular as an alternative to sedative anesthesia. One study found that switching to this method, along with reducing the number of surgical supplies used for smaller procedures, resulted in a reduction of 2.8 tons of waste and more than $13,000 in supplies.

Dr. Freddy Foo, who is a posthumous co-author of the paper, was instrumental in initiating this project. Before his death, Dr. Fu invited the team at his beloved UPMC sports complex to share their passion for understanding environmental influences.

“I remember one of the last things Dr. Fu said to me: ‘I thought I knew all about ACL surgery, and now this team is going to teach me something new,'” Belk said.

Engler and Curley recalled Dr. Fu’s enthusiasm for this study: “Dr. Fu was immediately supportive of our passion for sustainability. He was willing to help in any way he could. For someone known for his boundless passion, he continued to define himself through his final days.”

The team is honored to continue this work in its legacy.

The paper, “Environmental Sustainability in Orthopedics” (DOI: 10.5435 / JAAOS-D-21-01254) published in Journal of the AAOS and co-authored by Ian de Engler, Andrew J. Curley, Freddy H. Vo, and Melissa M. Belk.

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