{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T13:19:45Z","timestamp":1782998385726,"version":"3.54.5"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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 tCO<jats:sub>2<\/jats:sub>\u2010e\u2009=\u2009Q\u2009\u00d7\u2009EF, where Q is waste weight, EF is the emission factor (0.879), and tCO<jats:sub>2<\/jats:sub>\u2010e is tonnes of carbon dioxide emissions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Across 60 procedures, 425.7\u2009kg of waste was generated, averaging 8.2\u2009kg per case. TKA produced the most waste (11.7\u2009kg per case), while hand injury surgeries generated the least (3.9\u2009kg 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\u2009t of CO<jats:sub>2<\/jats:sub>\u2010emissions annually from TKA alone in Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.70018","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T04:20:11Z","timestamp":1740025211000},"page":"539-543","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Less trash, more treasure. Waste production and reduction in Orthopaedic surgery"],"prefix":"10.1111","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1962-9727","authenticated-orcid":false,"given":"Nikolas","family":"Drobetz","sequence":"first","affiliation":[{"name":"Lismore Base Hospital  60 Uralba St Lismore New South Wales 2480 Australia"},{"name":"Bond University  14 University Dr Robina Queensland 4226 Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7598-6482","authenticated-orcid":false,"given":"Joshua","family":"Xu","sequence":"additional","affiliation":[{"name":"Lismore Base Hospital  60 Uralba St Lismore New South Wales 2480 Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Chang","sequence":"additional","affiliation":[{"name":"Lismore Base Hospital  60 Uralba St Lismore New South Wales 2480 Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Hazan","sequence":"additional","affiliation":[{"name":"Lismore Base Hospital  60 Uralba St Lismore New South Wales 2480 Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3849-1751","authenticated-orcid":false,"given":"William","family":"Collins","sequence":"additional","affiliation":[{"name":"Lismore Base Hospital  60 Uralba St Lismore New South Wales 2480 Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0837-2696","authenticated-orcid":false,"given":"Herwig","family":"Drobetz","sequence":"additional","affiliation":[{"name":"Lismore Base Hospital  60 Uralba St Lismore New South Wales 2480 Australia"},{"name":"School of Medicine The University of Sydney  Robina Queensland 4226 Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resconrec.2021.105556"},{"key":"e_1_2_7_3_1","unstructured":"Australian Government.2016Net Zero. Available from URL:https:\/\/www.dcceew.gov.au\/climate-change\/emissions-reduction\/net-zero."},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2010.343"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2024.103910"},{"key":"e_1_2_7_6_1","first-page":"33","volume-title":"Australian national greenhouse accounts factors","author":"Australian Government","year":"2023"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1503\/cjs.015711"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2012.04.020"},{"key":"e_1_2_7_9_1","first-page":"17","article-title":"Invisible costs\/visible savings: innovations in waste management for hospitals","volume":"2","author":"Shaner H","year":"1996","journal-title":"Surg. Serv. 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Available from URL:https:\/\/www.aihw.gov.au\/reports\/injury\/injury-in-australia\/contents\/nature-of-injuries\/type-of-injury."},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-13-224"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70018","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T07:24:54Z","timestamp":1755588294000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.70018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,20]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1111\/ans.70018"],"URL":"https:\/\/doi.org\/10.1111\/ans.70018","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,20]]},"assertion":[{"value":"2024-12-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}