Environmental life cycle assessment of surgical versus conservative care pathways for an anterior cruciate ligament injury

Article Article scientifique Article Environmental life cycle assessment of surgical versus conservative care pathways for an anterior cruciate ligament injury eng 2025-12-10 author Boiko Polina 0009-0009-6112-1336 751167 author Bruyneel Anne-Violette 0000-0003-4764-9336 author Ray Nicolas 0000-0002-4696-5313 126189 Institut de santé globale (COSPR) author Tscholl Philippe 0000-0003-1702-7114 843098 author Patel Martin Kumar 0000-0002-3983-6003 810106 Forel Communs (FOREL) 147136 10.1016/j.jclepro.2025.147136 0959-6526 https://www.sciencedirect.com/science/article/pii/S095965262502493X Environmental degradation is a major global health threat, and the healthcare sector functions as both its victim and perpetrator. To effectively inform mitigation strategies it is essential to quantify the environmental burden originating from healthcare activities and then favour environmentally preferable treatment options. This Switzerland-based study evaluated and compared the environmental impacts from surgical and conservative care pathways after an anterior cruciate ligament injury using Life Cycle Assessment; it also identified the environmental hotspots stemming from the surgery itself, as well as from physiotherapy. Environmental impacts were quantified across 18 ReCiPe midpoint impact categories. Results indicated that, on average, after an anterior cruciate ligament injury, the surgical pathway imposes at least an 8.5-fold greater relative environmental burden than the conservative pathway. Regarding the anterior cruciate ligament surgery alone, the hotspots of environmental impacts were identified as the manufacturing of single-use products, transportation of patient and staff, and the use of heating-ventilation-air-conditioning and electricity. Regarding physiotherapy, results indicated that a large share of environmental impacts can be attributed to transportation of patient and staff, laundry, and space heating. This difference in environmental impacts emphasises the importance of a careful patient allocation between these two care pathways. Recommendations to reduce the environmental impacts from surgery should prioritise investing in reusable equipment, streamlining surgical instrument trays, and opting for occupancy-based heating- ventilation-air-conditioning. To reduce the environmental impacts originating from physiotherapy, recommendations should encourage soft mobility, patient’s self-management, and the physiotherapist’s following of evidence-based guidelines. Reducing laundry frequency can be relevant as well. Life cycle assessment Anterior cruciate ligament Surgery Physiotherapy Dewey 550 Dewey 613 Dewey 617 Dewey 333.7-333.9 18 Institut des sciences de l'environnement 0DB 66 Institut de santé globale 22A1 41 Département F.-A. Forel des sciences de l'environnement et de l'eau 153 57 Département de chirurgie 222 false 941 ISE Pôle Informatique environnementale 1275 GeoHealth: approches géospatiales et environnementales en santé globale 1000 935 Energy efficiency 1057 TIGERS Journal of cleaner production 535 c155b0ef-6c33-4e41-9464-247719308792 Article (Published version) Public 1-s2.0-S095965262502493X-main.pdf 7771490 application/pdf CC BY-4.0 c227ef7244be158265e13048c2bef211633b83ce3f0f7f9060da55a9c33dce00 1319a208-7597-468d-93fb-26cb2eb6173f Supplemental data Public 1-s2.0-S095965262502493X-mmc1.docx 950295 application/vnd.openxmlformats-officedocument.wordprocessingml.document 0954f3e06542f0f0fd8a0f30fe613cce20775531b7a5eb45190936f461386388 openAccess Centres et instituts / Institut des sciences de l'environnement Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires / Institut de santé globale Faculté des sciences / Section des sciences de la Terre et de l'Environnement / Département F.-A. Forel des sciences de l'environnement et de l'eau Faculté de médecine / Section de médecine clinique / Département de chirurgie

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Environmental life cycle assessment of surgical versus conservative care pathways for an anterior cruciate ligament injury	Journal of cleaner production			2025	22	129

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Boiko, Polina