Quantitative and Qualitative Analysis of Surgical Waste in TKA and THA at Kolar Tertiary Care Center : Its Effect on Environment

Abstract

Background and Objective: Total knee arthroplasty (TKA) and total hip arthroplasty (THA) procedures produce considerable amounts of surgical waste, which have notable environmental consequences. This prospective observational study was conducted to quantitatively and qualitatively analyze the surgical waste generated during TKA and THA surgeries at a tertiary care center in Kolar. The study focused on evaluating the composition of the waste, the practices of waste segregation, and the associated environmental impact.

Methods: This prospective observational study examined surgical waste generated from primary arthroplasty procedures conducted at R L Jalappa Hospital and Research Center, Kolar, between March 2024 and January 2025. A total of twenty primary arthroplasty procedures, comprising ten total knee arthroplasties (TKA) and ten total hip arthroplasties (THA), were evaluated for waste generation and composition. Data collection involved the prospective quantification of waste by category—general, hazardous, recyclable, sharps, and linens—in accordance with the Biomedical Waste Management Rules 2016. Additionally, waste composition analysis and calculation of environmental impact, including carbon emissions, were performed. A qualitative assessment of staff practices and awareness regarding waste segregation was also conducted. Statistical analyses were carried out using SPSS version 22, with significance defined at p < 0.05.

Results: The average total waste generated per procedure was 48.3 ± 7.2 kg for total knee arthroplasty (TKA) and 42.1 ± 5.8 kg for total hip arthroplasty (THA), with the difference reaching statistical significance (p = 0.048). Waste composition was distributed as follows: hazardous waste constituted 42% (20.3 kg for TKA, 17.6 kg for THA), general waste accounted for 35% (16.9 kg for TKA, 14.7 kg for THA), and recyclable materials comprised 23% (11.1 kg for TKA, 9.8 kg for THA). Single-use items represented 78% of the total waste generated. The carbon emissions associated with waste were 82.4 ± 12.3 kg CO₂-equivalent for TKA and 71.6 ± 9.7 kg CO₂-equivalent for THA. Compliance with appropriate waste segregation protocols was 75%, whereas only 30% of staff exhibited adequate awareness of the environmental impact. Economic analysis revealed that waste management costs were ₹11,850 per TKA and ₹10,420 per THA.

Conclusions: Total knee arthroplasty (TKA) and total hip arthroplasty (THA) procedures generate substantial surgical waste, thereby contributing significantly to environmental impact. The prevalent reliance on single-use items, coupled with insufficient recycling practices, underscores opportunities for waste reduction. Implementing improved waste segregation protocols, transitioning to reusable alternatives where feasible, and delivering comprehensive staff training could potentially decrease waste production by 30–40% without compromising patient safety.