Lidgren, L

Raina, DB

Tanner, KE

Tägil, M

Acta Orthopaedica Scandinavica

English

Lidgren, Lars

Raina, Deepak Bushan

Tägil, Magnus

Tanner, K. Elizabeth

Lund University Publications

Recycling implants : a sustainable solution for musculoskeletal research

Queen Mary Research Online

CJournalLatest ArticlesActa Orthopaedica ∠0Views 0CrossRef citations to date 11AltmetricArticlesRecycling implants: asustainable solution formusculoskeletal research,Lars Lidgren " ,Deepak Bushan Raina  &Magnus TägilK Elizabeth TannerPublished online: 06 Jan 2020Published online: 06 Jan 2020# Download citation  $ https://doi.org/10.1080/17453674.2019.1706301  % Figures & data ∠& References ∠# Citations ∠Listen' Full Article Showing () Log in  |  RegisterF|Metrics ∠+ Licensing ∠About half a million people in Sweden (5%) (10.5 millioninhabitants) walk around with a bone or joint implant. This couldbe extrapolated to 50 million only in the Americas, Europe, andthe Paciﬁc. Orthopedic surgeons are running the largestworkshop for repairing humans worldwide, and, in fact, one-ﬁfthof all people older than 75 years in Sweden have an artiﬁcial joint.In the United States, 5–10% of all hip or knee implants are beingrevised during a lifetime (Malchau et al. 2018).The environmental as well the ﬁnancial aspects of recyclingmetals at revision or post-mortem has thus far not beenprioritized on the orthopedic societies’ agendas.Close to 100,000 Swedes pass away annually, with 70% beingcremated. To protect the environment, the Swedish Governmentchanged its regulation in 2016, making it mandatory for theSwedish Church—which is responsible for all funerals—toarrange for recycling after cremations of all metal componentsincluding the coﬃn. Since 2016, all metal collected at cremationhas been recycled (Figure), resulting in 60 tons of valuable metals+(such as, for instance, titanium) at a net value of US$15 million.The recycling company, however, charges 20%, while 80% isplowed back to support societal projects handled by a largegeneral inheritance fund (Hyckenberg 2019). If the Swedishﬁgures were extrapolated to Europe and the United States alone,the total income from metal recycling at funeral would be aroundUS$250 million annually (i.e., 700 million inhabitants, assuming1% mortality per year, 50% cremation and if 20% had a metaldevice at death) (The Cremation Society 2019).In addition, recycling of extracted implants that are currentlyscrapped as dangerous goods should be possible if the logisticsfor collection could be handled properly. This could be doneunder the auspices of the national orthopedic societies. With anexpected minimal cumulative revision rate of 5% leading to arevision arthroplasty, this recycling in Sweden should give ayearly recurring income close to US$500,000, which could bedirected to orthopedic research. Given the ongoing “age quake”and an increasing cremation trend in the industrialized world,metal implant recycling—which has just started in Sweden—islikely to spread to other countries.Leading implant manufacturers are encouraged to startcollaborating with the orthopedic societies, who should assumetheir environmental responsibility and facilitate recycling of metalimplants both at revision and at post-mortem. This has to bedone in a manner respectful to the deceased and his or her lovedones.In cooperation with patient organizations, we suggest thatorthopedic societies put forward a motion to governments that atleast part of the income from such recycling be directed tomusculoskeletal research in the respective countries.1. Malchau H, Garellick G, Berry D, Harris W H, Robertson O,Kärrholm J, Lewallen D, Bragdon C R, Lidgren L, Herberts P.Arthroplasty implant registries over the past ﬁve decades:Development, current, and future impact. J Orthop Res 2018;36 (9): 2319–30. [Crossref], [PubMed], [Web of Science ®], [Google Scholar]2. Hyckenberg A. Återvinning av metaller. (2019)https://www.svenskakyrkan.se/sollentuna/nyheter/atervinning-av-metaller. [Google Scholar]3. The Cremation Society, Cremation Statistics. (2019)https://www.cremation.org.uk/statistics. [Google Scholar] Information forAuthorsEditorsLibrariansSocietiesOpen accessOverviewOpen journalsOpen SelectCogent OAHelp and infoHelp & contactNewsroomCommercial servicesAll journals, Sign me up - ./ 0Keep up to dateRegister to receive personalised research and resources by emailCopyright © 2020 Informa UK LimitedPrivacy policyCookiesTerms & conditionsAccessibilityRegistered in England & Wales No. 30990675 Howick Place | London | SW1P 1WGLoading [Contrib]/a11y/accessibility-menu.js

Recycling implants: a sustainable solution for musculoskeletal research

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Recycling implants: a sustainable solution for musculoskeletal research

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