How to achieve extra environmental sustainability in orthopedics?

Environmental sustainability in orthopedics is a growing field with considerable potential for impactful change. A systematic review focusing on orthopedic surgery found that large joint arthroplasties, like primary total knee replacements (TKRs), are among the largest contributors to waste in orthopedic procedures. The review, which followed PRISMA guidelines and analyzed studies on waste management in TKRs, found that the average waste per TKR was 13.1kg, with up to 69.9% classified as hazardous.

Interestingly, up to 43% of this waste could potentially be recycled. This information aligns with the broader understanding that orthopedic surgery, being high-volume and energy-intensive, contributes notably to the healthcare sector’s greenhouse gas emissions. It’s therefor imperative that surgeons are encouraged to integrate sustainability into their practice patterns, which could include reducing equipment use and waste, thus aligning with both cost savings and environmental benefits.

Crucial role of environmental sustainability in orthopedics

Healio, a magazine for health care professionals, has published an article about the crucial role of environmental sustainability in orthopedics, highlighting the significant waste and emissions generated by this medical specialty. In the article orthopedic surgeons are encouraged to incorporate sustainability practices into their operations and discussions, given their substantial environmental impact within healthcare.

The challenges faced include the culture of disposability in orthopedic operating rooms and the balance between productivity and sustainable practices. However, by adopting sustainable practices, orthopedic surgeons can significantly influence environmental sustainability within their field, contributing to the mitigation of climate change’s impact on population health while maintaining high standards of patient care.

How to Promote Sustainability in Practice

Orthopedic surgeons, with their autonomy and leadership roles, are uniquely positioned to champion sustainability in healthcare. From minimizing disposables in operating rooms to embracing telehealth, these steps not only reduce environmental impact but also enhance overall healthcare efficiency.

And we shouldn’t underestimate the role of orthopedic societies and journals in setting sustainability standards and spreading best practices. They should promote environmentally responsible practices within the broader medical community.

Practical Cases of Sustainable Actions in Orthopedics

Practical Cases of Sustainable Actions in Orthopedics
Practical Cases of Sustainable Actions in Orthopedics

Emphasizing sustainable practices in orthopedics aligns with broader healthcare goals of reducing costs and increasing efficiency. It’s crucial to recognize that adopting sustainable measures does not lead to inefficiency or compromise patient safety but rather benefits all stakeholders involved in healthcare.

These are 8 measures which should be implemented in the medical community (and beyond).

  1. Waste Management: One of the most direct ways orthopedic departments can contribute to sustainability is through improved waste management. This involves identifying recyclable materials, reducing the use of single-use items, and properly segregating waste to minimize the amount sent to landfills. Some orthopedic departments have started conducting waste audits to understand their waste streams better and identify opportunities for reduction.
  2. Energy-Efficient Practices: Operating rooms are energy-intensive spaces. Implementing energy-efficient practices, such as using LED lighting and optimizing the use of energy-intensive equipment, can significantly reduce the carbon footprint. Some hospitals are also exploring renewable energy sources, such as solar panels, to power their facilities.
  3. Sustainable Procurement: Choosing suppliers and medical products that prioritize sustainability is another area of focus. This includes selecting products with less environmental impact, such as those with reduced packaging or made from sustainable materials. In orthopedics, this might also involve selecting implants and prosthetics that have a longer life or are made with more sustainable materials.
  4. Telemedicine and Patient Travel Reduction: Telemedicine has become increasingly popular, especially accelerated by the COVID-19 pandemic. In orthopedics, virtual consultations can reduce the need for patient travel, thereby lowering the carbon footprint associated with patient care.
  5. Education and Research: Increasing awareness and education about environmental sustainability in orthopedics is crucial. This involves training staff and conducting research on the environmental impact of various practices and the effectiveness of different sustainability initiatives.
  6. Collaboration and Policy Making: Collaboration among healthcare professionals, policymakers, and industry partners is essential to drive systemic change. This includes advocating for policies that support environmental sustainability in healthcare and partnering with industry to develop more sustainable medical products and technologies.
  7. Innovations in Surgical Techniques: Some orthopedic surgeons are exploring less invasive surgical techniques that require fewer resources and generate less waste. This also includes re-evaluating the necessity of certain procedures and optimizing surgical efficiency.
  8. Green Buildings and Hospital Design: The design of hospital facilities can significantly impact their environmental footprint. Green building designs, which include efficient heating and cooling systems, better insulation, and eco-friendly materials, are becoming more common in healthcare facilities, including orthopedic departments.

Sustainability and the Green Agenda in Orthopaedic Surgery in the UK

In the below video, titled “Sustainability and the Green Agenda in Orthopaedic Surgery”, UK specialists explore the latest NHS developments in sustainability in orthopaedic surgery.

Speakers include Irrum Afzal (South West London Elective Orthopaedic Centre (SWLEOC)), Sian Langford and Phil Davies (The Robert Jones and Agnes Hunt Orthopaedic Hospital), and Virginia Ledda (University of Birmingham).

These practical cases demonstrate how a growing awareness and commitment to environmental sustainability within the orthopedics industry can be obtained. But the transition to more sustainable practices can be challenging, nevertheless it is a critical step in reducing the environmental impact of healthcare and contributing to the broader goal of sustainable development.