Life cycle assessment and optimisation of surgical instrument trays for reverse shoulder arthroplasty

Journal Article (2025)
Author(s)

Isabella C. Klarenbeek (Maastricht University Medical Center, Viecuri Hospital)

Anne C. van der Eijk (TU Delft - Medical Instruments & Bio-Inspired Technology, Leiden University Medical Center)

Esther R.C. Janssen (Radboud University Medical Center, HAN University of Applied Sciences, Viecuri Hospital)

Freek Hollman (Viecuri Hospital, Maastricht University Medical Center)

Paul C. Willems (Maastricht University Medical Center)

Okke Lambers Heerspink (Viecuri Hospital, Maastricht University Medical Center)

DOI related publication
https://doi.org/10.1177/17585732251315424 Final published version
More Info
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Publication Year
2025
Language
English
Journal title
Shoulder and Elbow
Issue number
6
Volume number
17
Pages (from-to)
801-808
Downloads counter
222
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Abstract

Objectives
Shoulder arthroplasty has a large environmental impact. Part of the environmental impact is caused by the sterilisation of surgical instruments. This study examines the effect of optimising surgical instrument trays for reverse shoulder arthroplasty (RSA), to reduce the environmental impact.

Methods
An adjusted LEAN 5s method was used to optimise the number of instruments of shoulder arthroplasty specific trays. A Life Cycle Assessment was performed to calculate the CO2-eq.

Results
After careful selection, 139 of the 254 (55%) instruments were removed from the original RSA trays. Out of the 139 removed instruments, 19 were placed in a supplemental tray. The number of base trays was reduced with 3 trays. The estimated impact by reducing these trays from the standard pre-operative setup is a reduction of 28% of the environmental impact annually (524 kg CO2 equivalent).

Discussion
This study confirms the feasibility of optimising instrument trays for RSA, offering a straightforward method to reduce the environmental impact of shoulder arthroplasty. Our results show that strategic instrument selection can contribute to lowering the environmental impact of orthopaedic surgery.