Purpose: The purpose of this study was two-fold. First, we wanted to compare the cost of liquid waste disposal from the operating rooms (ORs) via a 3rd party medical waste company, with utilization of the sewer system at Kingston General Hospital. Secondly, we sought to assess national trends in liquid waste disposal, in order to make a national recommendation for liquid waste disposal from the OR.

Method: The hospital cost for OR liquid waste disposal at Kingston General Hospital was calculated by weighing the liquid waste from 871 surgical cases over a 5-week period in 2008. The materials, manpower and weight of the waste were used to calculate the costs for the two methods of liquid waste disposal. Seventy teaching hospitals across Canada were surveyed to determine their practice of liquid waste disposal in the OR.

Results: The raw cost per kg of liquid waste disposal using a medical waste company was found to be 57.126 % greater than utilizing the sewer system. Using the sewer system resulted in a total cost reduction of 40% compared with using a medical waste company. Sixty-three out of seventy teaching hospitals across the nation (90%) were found to utilize medical waste companies, while seven out of seventy hospitals (10%) utilized the sewer system to dispose of liquid waste.

Conclusion: The sewer system is an under-utilized yet safe, legal, and cost effective way to dispose of liquid waste from the OR. Using the sewer system to dispose of liquid waste would save the Canadian health care system millions of dollars compared with disposal via medical waste companies.

Ten New Zealand White rabbits underwent anterior cruciate ligament transection (ACLX), then reconstruction using a mersiline tape graft and mitek mini anchors. Animals were divided into two groups and sacrificed at six and fourteen week after surgery. Medial collateral ligament (MCL)-complexes were evaluated for joint laxity, and periarticular tissues evaluated for changes in vascular volume. Both reconstructed groups showed significantly reduced MCL-complex laxity and inflammatory angiogenesis compared to ACLX controls. This reconstructive method (using an artificial graft) provided transient restabilization out to 6 and 14 wk after ACLX in the rabbit, with a high 80% success rate of intact grafts.

To refine a method of ACL reconstruction in the New Zealand White (NZW) rabbit to study angiogenic adaptations in a restabilized knee joint.

The artificial graft approach provided transient restabilization out to six and fourteen week post ACLX with an 80% success rate, and reduced MCL-complex laxity and inflammatory angiogenesis.

Addressing joint instability after ACLX reduces inflammatory angiogenesis and mechanical deterioration in peri-articular tissues, and delays the progression of OA.

Compared to normal control tissues, loss of the ACL resulted in marked joint instability, and significantly increased vascular volumes in all periarticular tissues examined six and fourteen week post-ACLX. However, following transient restabilization using reconstructive surgery, MCL-complex laxity and periarticular tissue vascular volume were significantly reduced at both the six and fourteen week intervals compared to ACLX controls.

ACL reconstructive surgery was performed on the right knee of ten skeletally mature NZW rabbits using a mersiline tape graft and mitek mini anchors, immediately after the ACL had been transected. MCL-complex laxity was measured in all joints using established biomechanical procedures. To assess the effect of joint restabilization six and fourteen week after ACL reconstruction, limbs were infused with a 5% carmine red dye/5% gelatin solution, and the vascular volume of periarticular tissues was detemined.

The artificial graft approach to rabbit ACL reconstruction resulted in a high success rate of intact grafts 6 and 14 wk post-ACLX. The transient restabilization of an ACLX knee joint results in less inflammatory angio-genesis in periarticular tissues.

Funding: CIHR