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Reprocessing Single-Use Devices: An Orthopaedic Perspective
Robby S. Sikka, BA1; David A. Fischer, MD2; Marc F. Swiontkowski, MD3
1 4295 Via Arbolada, Apartment 204, Los Angeles, CA 90042
2 TRIA Orthopaedic Center, 8100 Northland Drive, Bloomington, MN 55431
3 Department of Orthopaedic Surgery, University of Minnesota, 2450 Riverside Avenue, Suite R200, Minneapolis, MN 55454. E-mail address: swion001@umn.edu
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The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Investigation performed at the TRIA Orthopaedic Center, Bloomington, and the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2005 Feb 01;87(2):450-457. doi: 10.2106/JBJS.D.02501
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In response to increasing environmental and economic pressure, the reuse of single-use devices has become more prevalent in the United States. Managed care and Medicare have reduced reimbursements in the past decade, and annual surgical waste from common operations of the back, knee, and hip has increased to a reported weight of 1.84 × 107 lb (8.3 × 106 kg) and a volume of 5 × 106 ft3 (1.42 × 105m3)1,2. Consequently, hospitals and surgery centers have sought to cut expenditures and reduce the amount of surgical waste produced. One method that a quarter of the hospitals in the United States have begun to use is the reuse of disposable surgical equipment. Studies involving angioplasty balloons, cardiac catheterization wires, trocars for laparoscopic surgery, cytology brushes for bronchoscopic sampling, surgical draping, and endoscopic equipment have all been evaluated to see whether use of reprocessed single-use devices is efficacious, cost-effective, and environmentally sound3-5. The majority of studies on the cost-effectiveness and efficacy of reprocessed single-use devices have been on endoscopy equipment. Wilcox reported, in 2000, that it was both financially and environmentally sound to use reprocessed single-use devices for endoscopic surgery, and subsequent studies have confirmed these findings3. Another recent study has revealed a substantial economic advantage in the reuse of pacemakers without any appreciable risk of infection6,7. At the time of writing, we knew of no published report evaluating the quality of reused single-use devices in orthopaedic surgery. The present paper presents information regarding the current regulations and standards governing the reuse of single-use devices.
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