Clean Joints, Clean Planet: A Review of Literature on Sustainable Practices in Orthopaedic Joint Replacements.

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Abstract

Conflict of interest statement: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. 2. Cureus. 2026 Jan 9;18(1):e101151. doi: 10.7759/cureus.101151. eCollection 2026 Jan. Use of Ultraviolet C-Radiation Therapy in Trauma and Orthopaedics: A Current State of Evidence. Giannoudis VP(1)(2), King SW(1)(2), Matthews H(3), Rodham PL(1), Vickers O(4), Pandit H(5), Van Duren B(5)(6). Author information: (1)Trauma and Orthopaedics, Leeds Teaching Hospitals Trust, Leeds, GBR. (2)Trauma and Orthopaedics, University of Leeds, Leeds, GBR. (3)Trauma and Orthopaedics, Huddersfield Royal Infirmary, Huddersfield, GBR. (4)Leeds Orthopaedic and Trauma Sciences, School of Medicine, University of Leeds, Leeds, GBR. (5)Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, GBR. (6)Hip and Knee Arthroplasty Surgery, Nottingham Elective Orthopaedic Service, Nottingham, GBR. Ultraviolet-C (UV-C) radiation exhibits potent germicidal capabilities through DNA and RNA damage in microorganisms. Its utilisation in orthopaedics began primarily for theatre sterilisation. Current applications focus extensively on surface, air, and equipment sterilisation within orthopaedic theatres. The aim of this scoping review was to establish the current uses and practices of UV-C in orthopaedic surgery. A comprehensive literature review was conducted according to PRISMA guidelines, sourcing articles from PubMed/MEDLINE and Google Scholar from inception till January 2025. Studies included addressed UV-C applications in orthopaedic sterilisation and disinfection, financial analyses, and clinical infection outcomes. Data extracted included study parameters, methods, UV-C exposure specifics, microbial colony counts, and outcomes. Out of 2574 articles identified initially, 23 studies met the inclusion criteria. Fifteen articles addressed UV-C sterilisation, highlighting substantial microbial reductions on theatre surfaces and equipment, although effectiveness varied by organism and exposure duration. Eight studies investigated UV-C's impact on infection rates and skin health, showing significant infection reduction in arthroplasty cases without major adverse dermatological effects. Financial analysis was available from only one study, which indicated significant cost savings compared to traditional methods. UV-C radiation appears effective in reducing microbial contamination in orthopaedic theatres, complementing traditional cleaning practices. It offers promising infection reduction in arthroplasty with manageable safety concerns. Indeed, use of UV-C may be an efficient way of reducing infection risk without the need for antibiotic use, and this can contribute to reduction in the risk of antimicrobial resistance. Future research should focus on refining protocols and exploring broader clinical and economic impacts. Copyright © 2026, Giannoudis et al. DOI: 10.7759/cureus.101151 PMCID: PMC12883074