{"title":"Bone cement in total hip arthroplasty – Is it really green?","authors":"","doi":"10.1016/j.surge.2024.04.010","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Total hip replacement (THR)is typically cemented, cementless or hybrid depending on patient factors and surgeon preference. To date no studies have evaluated waste generated with each of these procedures in relation to implant choice, and particularly waste related to consumables. We aimed to quantify the volume; type and ability to recycle this waste and suggest potential strategies for reducing the overall waste related to consumables in THR.</p></div><div><h3>Method</h3><p>This was a prospective review of all waste related to consumables in THR. The waste was weighed using a Salter 1066 BKDR15 scale, accurate to the nearest 1 g. The primary outcome was the amount of waste generated per case depending on implant choice (cemented vs. uncemented). Secondary outcomes included: proportion of clinical waste and proportion of recyclable waste.</p></div><div><h3>Results</h3><p>Cemented THR generated a total of 1.89 kg of waste compared to 775 g for an uncemented THR. Cemented THR generated significantly more sterile (hazardous) waste than uncemented THR both as overall volume and as a proportion 763 g (40%) vs 76 g (10%). Significantly more of the waste related to uncemented THR was amenable to being recycled through conventional waste streams with simple changes in theatre 672 g (86%) compared to 989 g (52%) with cemented THR. Between 20 and 30% of waste packaging for both types of surgery compromised information booklets.</p></div><div><h3>Conclusion</h3><p>Cemented hip replacement generates significantly more waste from consumables than uncemented and a greater amount of this waste is hazardous requiring intensive processing. For both implants a significant proportion of waste can be recycled with simple process changes in theatre. Industry partners have a responsibility to minimise unnecessary packaging and work with surgeons to improve sustainability.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":"22 4","pages":"Pages 227-232"},"PeriodicalIF":2.3000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1479666X24000428","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Total hip replacement (THR)is typically cemented, cementless or hybrid depending on patient factors and surgeon preference. To date no studies have evaluated waste generated with each of these procedures in relation to implant choice, and particularly waste related to consumables. We aimed to quantify the volume; type and ability to recycle this waste and suggest potential strategies for reducing the overall waste related to consumables in THR.
Method
This was a prospective review of all waste related to consumables in THR. The waste was weighed using a Salter 1066 BKDR15 scale, accurate to the nearest 1 g. The primary outcome was the amount of waste generated per case depending on implant choice (cemented vs. uncemented). Secondary outcomes included: proportion of clinical waste and proportion of recyclable waste.
Results
Cemented THR generated a total of 1.89 kg of waste compared to 775 g for an uncemented THR. Cemented THR generated significantly more sterile (hazardous) waste than uncemented THR both as overall volume and as a proportion 763 g (40%) vs 76 g (10%). Significantly more of the waste related to uncemented THR was amenable to being recycled through conventional waste streams with simple changes in theatre 672 g (86%) compared to 989 g (52%) with cemented THR. Between 20 and 30% of waste packaging for both types of surgery compromised information booklets.
Conclusion
Cemented hip replacement generates significantly more waste from consumables than uncemented and a greater amount of this waste is hazardous requiring intensive processing. For both implants a significant proportion of waste can be recycled with simple process changes in theatre. Industry partners have a responsibility to minimise unnecessary packaging and work with surgeons to improve sustainability.
期刊介绍：
Since its establishment in 2003, The Surgeon has established itself as one of the leading multidisciplinary surgical titles, both in print and online. The Surgeon is published for the worldwide surgical and dental communities. The goal of the Journal is to achieve wider national and international recognition, through a commitment to excellence in original research. In addition, both Colleges see the Journal as an important educational service, and consequently there is a particular focus on post-graduate development. Much of our educational role will continue to be achieved through publishing expanded review articles by leaders in their field.
Articles in related areas to surgery and dentistry, such as healthcare management and education, are also welcomed. We aim to educate, entertain, give insight into new surgical techniques and technology, and provide a forum for debate and discussion.
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