When staff at military hospitals and clinics faced a national crutch shortage in 2020, they launched a crutch collection and reuse initiative to ensure patient care. These efforts created a new waste reduction best practice within the Defense Health Agency.

During the COVID-19 pandemic, global aluminum shortages caused a nationwide shortage of aluminum crutches. “At one point, it took more than four months to get a pair of medium crutches,” said Jill Low, a physical therapy assistant supervisor at Evans Army Community Hospital in Fort Carson, Colorado. In some cases, the shortages were so severe that several hospitals and clinics considered pausing orthopedic surgeries.

MTFs started taking the initiative to collect and reuse unwanted crutches.

As the military hospital and clinic staff worked to manage additional waste loads, this practice reduced the number of crutches that would typically be sent to landfills after patients recovered. “I noticed crutches would be thrown in the trash, so I asked if I could have them [to sanitize and reuse for other patients],” said Edith Valenzuela, a physical therapy assistant at William Beaumont Army Medical Center in Fort Bliss, Texas, who was motivated to help patients and reduce waste.

The reuse and reduction benefits the environment and public health, including reduced pressure on waste and recycling streams and decreased greenhouse gases and air pollution from waste incineration or landfill disposal.

With approval from their crutch manufacturer, hospital leadership, and the infection control division, physical therapy offices began reaching out to their local community to collect used crutches. “We spread word throughout the facility to bring any crutches lying around, and suddenly, there were 75 crutches at our door,” said Dr. Teddy Ortiz, a physical therapist at Brooke Army Medical Center at Fort Sam Houston, Texas.

Physical therapy offices posted signs around the facility encouraging patients to return their unwanted crutches. Some military hospitals and clinics posted on social media to get the word out about collection efforts, requesting donations from the wider community on base. With these strategies, there was an impressive response.

Military hospitals and clinics leveraged their entire physical therapy office—receptionists, physical therapists, and doctors—to participate in crutch reuse efforts. Once quality was assured and necessary parts replaced, crutches were wiped down with nonabrasive antibacterial wipes, labeled, and moved to appropriate storage until patients needed them.

As another added benefit, “DHA military treatment facilities reported a total cost savings of about $34,000 to $50,000 to date from reusing crutches,” said Mr. Roy Hirchak, facility operations branch chief and representative of the DHA Sustainability Program.

Crutch reuse, a sustainable practice brought on by the pandemic, leads to continued patient care, cost savings, and reduces the amount of waste that military hospitals and clinics send to landfills. “Waste built up during COVID, so we are trying to help the environment as much as possible by reusing the crutches,” said Valenzuela.

Although aluminum shortages will likely improve as the pandemic’s impacts abate, sustainable crutch reuse should continue and expand. “As DHA military hospitals and clinics look for new ways to reduce costs and environmental impacts, facilities should consider sustainably reusing crutches,” said Mr. Hirchak. "It helps the environment and contributes to resource savings."