Sustainability in foot and ankle surgery: Top tips and review of practices

Abstract

Orthopaedic surgery, particularly in foot and ankle procedures, generates significant waste, with the World Health Organization highlighting the potential for greener healthcare to benefit patient and worker health. This article reviews sustainability in foot and ankle surgery through the three pillars: Environmental, social, and economic. It examines cost-effective surgical practices, resource utilization, and operating theatre routines, noting the environmental impact of orthopaedic surgeries, such as the carbon emissions of up to 23.96 kg per lower limb arthroplasty. A gap in sustainability research specific to foot and ankle surgery was identified. Based on a narrative literature review of relevant studies, recommendations were developed for more sustainable practices in foot and ankle operations, including theatre practices, pre-operative setup, and post-operative care. The review collaborates existing literature to provide practical recommendations for optimizing surgical outcomes while reducing environmental impact.

Keywords: Foot and ankle; Sustainability; Orthopaedic surgery; Green surgery; Planet

Core Tip: The article covers the use of implants in foot and ankle surgery, with an emphasis on balancing effective outcomes and sustainability. The article critically analyzes the cost-effectiveness and necessity of laminar airflow in every case. It questions whether this infection prevention system is always needed, given its expense, and whether there are scenarios where it might not offer significant benefits. There’s a focus on using reusable drapes and patient setup devices to reduce waste in the operating room, aligning with more sustainable practices. The article explores eco-friendly alternatives for post-operative immobilization and casting, aiming to reduce the environmental impact of traditional materials.