University of Pittsburgh Study Assesses Environmental Impact of ALC Reconstruction

Engineers and physicians from the University of Pittsburgh studied how anterior cruciate ligament (ACL) reconstruction contributes to greenhouse gas emissions and searched for a way to reduce those effects.

The principal investigator was Melissa M. Bilec, PhD, Professor of Civil and Environmental Engineering at Pitt’s Swanson School of Engineering and co-director of the Mascaro Center for Sustainable Innovation. Bilec partnered with Fu and his team at the University of Pittsburgh School of Medicine’s Department of Orthopaedic Surgery, where he served as chair.

The study used the life-cycle assessment (LCA) method to analyze the entire life cycle of the product, including raw material extraction, manufacturing, distribution, use, and end-of-life. 

A paper on the study “How Can the Environmental Impact of Orthopaedic Surgery Be Measured and Reduced? Using Anterior Cruciate Ligament Reconstruction as a Test Case,” was published by Clinical Orthopaedics and Related Research. Nathalia Silva de Souza Lima Cano, MSc, Fulbright/CAPES PhD Fellow at Pitt was the author. 

“While life cycle assessment and material flow analysis (MFA) are tools in engineering and sustainability research, their potential has only recently been adapted to understanding the incredible impact that healthcare has on climate,” noted Bilec. “This ‘cradle-to-grave’ assessment takes a hard look at every product and process involved – in this case, with ACL surgery, everything from the materials used to make the devices used in surgery to the energy consumed, and the cost of disposing of the material. Partnerships with Pitt and UPMC are critical to advancing our collective strategic climate and environmental goals.”

The study found the carbon footprint for one ACLR to be 47 kg of carbon dioxide. It also found that 130,000 ACLRs each year in the U.S. produce approximately 6,110 metric tons of CO2eq per year.

“Though the most important priority in surgery is excellent patient care, surgeons can and should also be mindful of the carbon footprint of our surgeries,” said Ian Engler, MD, Orthopedic Sports Medicine Surgeon at the Central Maine Medical Center.