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. 2025 Jan 17:68:90-92.
doi: 10.1016/j.jor.2025.01.014. eCollection 2025 Oct.

Environmental impact of TKA: Waste audit of hospital operating room compared to ambulatory surgery center

Christopher E Bejcek  1 , Jeffrey R Baker  1   2 , Anthony G Sleiman  1 , Sowmyanarayanan V Thuppal  1   2 , Kristin Delfino  2 , D Gordon Allan  1   3
Affiliations

Environmental impact of TKA: Waste audit of hospital operating room compared to ambulatory surgery center

Christopher E Bejcek et al. J Orthop. .

Abstract

Introduction: The implications of global warming are ever increasing in today's society. As the number of total knee arthroplasties (TKA) performed in the USA increases annually, the total waste produced from them will proportionally increase. This study hopes to quantify and compare the amount of waste created by a TKA in a hospital operating room (OR) and ambulatory surgery center (ASC) to evaluate for any differences in the amount and types of waste created.

Methods: Waste audits were performed on 10 TKAs both at hospital OR and ASC OR. Waste was organized into 6 categories: normal solid waste, recyclable plastics, biohazard waste, laundered linens, sharps, and polypropylene blue sterile wrap. Weight and volume for each waste stream were recorded using a digital scale and ruler.

Results: The total mass of waste produced was higher in hospital based TKAs than in the ASC cases (17.3 kg vs. 14.0 kg, p-value = 0.0028). There was significantly more mass of sterile, normal, and sharps waste at the hospital-based cases. Sterile waste was the largest contributor to the mass of waste in both settings. No difference existed in volume of waste between the hospital and ASC cases (305,866 cm3 vs 260,052 cm3, p-value = 0.2494).

Discussion: TKAs in both settings produce a large amount of waste. Performing TKAs at ASCs could be used to lower the amount of waste produced, resulting in long term benefits to both the environment and the healthcare system.

Keywords: Ambulatory surgery center; Arthroplasty; Environment.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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