Less trash, more treasure. Waste production and reduction in Orthopaedic surgery

The operating theatre generates substantial waste, raising environmental concerns. This study quantified the waste generated during four common orthopaedic procedures and identified recyclable materials. It also assessed the associated carbon footprint to highlight opportunities for sustainable waste management.

This prospective study was conducted at a single regional hospital in New South Wales, Australia, from July to September 2024. Sixty procedures were analysed: 15 total knee arthroplasties (TKA), 15 total hip arthroplasties (THA), 15 ankle fracture fixations, and 15 hand injury surgeries. Waste was categorized as landfill, recyclable, or biohazardous. Landfill waste was further analysed for potentially recyclable components, with data extrapolated to nationwide operation numbers. Carbon dioxide emissions were calculated using the formula tCO₂-e = Q × EF, where Q is waste weight, EF is the emission factor (0.879), and tCO₂-e is tonnes of carbon dioxide emissions.

Across 60 procedures, 425.7 kg of waste was generated, averaging 8.2 kg per case. TKA produced the most waste (11.7 kg per case), while hand injury surgeries generated the least (3.9 kg per case). Potentially recyclable waste constituted 12% of landfill waste, with TKA having the highest recyclable proportion (13%). Recyclable materials comprised 44% of total waste. Proper segregation could reduce up to 75 t of CO₂-emissions annually from TKA alone in Australia.

A significant portion of orthopaedic theatre waste is recyclable, offering opportunities to reduce the carbon footprint of surgeries. Improved staff training and recycling facilities are crucial for optimizing waste management in healthcare.