Evidence map›Paper›PMID 40257588›Full record

Observational studyInternational orthopaedics2025

The cost of implant waste in trauma orthopaedic surgery and sustainability considerations: an observational study.

Rasi Mizori, Muhayman Sadiq, Yasser Al Omran, Charmilie Chandrakumar, Thomas Lewis, Omar Musbahi, Karthik Karuppaiah

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in International orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Rasi MizoriKing's College London, London, UK.
Muhayman SadiqKing's College London, London, UK.
Yasser Al OmranRoyal Free London NHS Foundation Trust, London, UK.
Charmilie ChandrakumarKing's College Hospital NHS Foundation Trust, London, UK.
Thomas LewisOrthopaedics and Arthritis Specialist Centre, Sydney, Australia.
Omar MusbahiImperial College London, London, UK. omusbahi@gmail.com.
Karthik KaruppaiahKing's College Hospital NHS Foundation Trust, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeImplant wastage in trauma and orthopaedic (T&O) surgery remains an under-reported yet significant issue, contributing to rising healthcare costs and environmental concerns. With increasing surgical demand driven by an ageing population and the growing prevalence of conditions like osteoporosis, this study aimed to quantify implant wastage in T&O procedures at a Level 1 Major Trauma Centre in London, assessing both its frequency and financial impact.

methodsA retrospective cohort study was conducted on all weekday T&O procedures performed between 1st December 2023 and 31st January 2024. Two of the authors identified wasted implants using intraoperative implant logbooks, and cross-referencing implant stickers with post-operative radiographs. Data pertaining to patient demographics, procedure types, surgical sites, and implant usage were collected. Cost analysis was performed using procurement data to determine the financial impact of implant wastage.

resultsAmong 184 procedures analysed, 131 (71.2%) used implants, with wastage observed in 108 (82.4%) cases. A total of 141 implants were wasted, with screws accounting for 92.9% (n = 131) of wasted implants. Locking screws were the most frequently discarded (n = 65; 46.1%). Across ORIF and intramedullary nailing procedures, an overall screw wastage rate of 20% (17-31%) was observed with 2.4 screws wasted per trauma procedure. The financial cost of implant wastage over the 44-day study period amounted to approximately £335 per day and £136 per case.

conclusionThis study highlights the substantial economic burden associated with implant wastage in T&O surgery, with screws, particularly locking screws, being the primary contributors. Targeted interventions, including improved preoperative planning, precision-based implant selection, and enhanced intraoperative decision-making, are essential to reducing waste and improving cost-efficiency and sustainability in surgical practices. Further research should explore the broader economic and environmental impact of implant wastage, incorporating factors such as operative time and carbon footprint to develop comprehensive waste-reduction strategies. LEVEL OF EVIDENCE: IV.

Indexed as

Medical WasteOrthopedic ProceduresProstheses and ImplantsAdultAgedAged, 80 and overBone ScrewsCosts and Cost AnalysisFemaleHumansLondonMaleMiddle AgedRetrospective StudiesTrauma CentersMedical WasteEconomic burdenEnvironmental impactHealthcare costsImplant wastageLocking screwsMedical devicesPreoperative planningSurgical inefficiencySustainabilityTrauma and orthopaedics

Identifiers

PMID40257588
PMCPMC12179003

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.