Table 3.
Summary of final studies included in this systematic review. Below are six studies reporting the weight of implant waste
| Author, Year; Country | Study Design | Primary Outcome | Duration of Study | Number of T&O procedures | Procedure type | Non-recyclable/Total Waste (kg) | Recyclable/Total waste (Kg) | Details of waste |
|---|---|---|---|---|---|---|---|---|
| Hennessy et al., 2021; Ireland | Prospective observational, single-centre cohort | Weight of implant packaging waste | 1 year | 209 | ORIF ankle, humerus and clavicle; hemiarthroplasty | 4.791/NR | NR |
2.768/4.791 kg was cardboard waste, 2.023/4.791 kg was plastic waste. In one ankle ORIF, 110 g (52%) of packaging waste was from screws |
| Huet et al., 2022; France | Prospective observational, single-centre cohort | Cost comparison of procedures using single-use and reusable instruments | 16 months | 46 | Distal radius fracture | NR/13.2 | NR/13.2 | The cost of using single-use implants and equipment (waste management, steralisation, staff) was less than re-usable equipment, but waste mangement was overall more expensive (€6500 vs. €6100) |
| Kooner et al., 2020; Canada | Multi-centre, prospective, observational cohort study | Quantifying the amount of recyclable and non-recyclable waste in 6 sub-specialties. | 30 days | 55 | Arthroplasty (14), trauma (10), sports (10), upper limb (12), paediatrics (5), foot and ankle (4) | 239/341 (70.1%) | 93.4/341 (27.4%) | Average of 21,928.2 kg intraoperative non-recyclable waste and 1,890.9 kg recyclable waste over 1 month. |
| Pegg et al., 2022; United Kingdom | Single-centre, prospective, observational cohort study | Amount of recyclable and non-recyclable waste | 2 days | 3 | THA (3) | 28.5/32.5 (87.7%) | 4.2/32.5 (12.9%) | Average waste per procedure was 10.9 kg. |
| Rammelkamp et al., 2021; United States | Single-centre, prospective, interventional study | Quantifying the amount of waste produced in an OR suite | 10 days | 23 | TKA (14), THA (3), TSA (6) | 304.1/337.4 (90.1%) | 33.3/337.4 (9.9%) | TKA produced the most waste per procedure (15.6 kg), followed by TSA (13.kg) and THA (41.4 kg). |
| Southorn et al., 2013; United Kingdom | Multi-centre, prospective, observational cohort study | Amount of waste produced by arthroplasty | 14 days | 32 | TKA (14), THA (18) | 178.6/380.2 (47.0%) | NR/380.2 | Total waste of 162.4 kg generated from TKA and 217.8 kg from THA |
Abbreviations: FJI, facet joint injection; NR, not reported; OR, operating room; ORIF, open reduction internal fixation; T&O, trauma and orthopaedics; THA, total hip arthroplasty; TKA, total knee arthroplasty; TSA, total shoulder arthroplasty